Isolated appendiceal metastasis in early ovarian carcinoma

Rose, Peter G.; Abdul‐Karim, Fadi W.

doi:10.1002/(sici)1096-9098(199703)64:3<246::aid-jso13>3.0.co;2-2

Cited by 17 publications

(5 citation statements)

References 8 publications

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“…The appendix is rarely involved (less than 4% of cases) in Stage I-II ovarian cancer [22,23]; it is involved mainly in mucinous tumors (up to 8%) [24]. Although it is generally associated with other extraovarian spread, appendiceal metastasis (even if grossly normal) can occur as the only extra-ovarian spread in early ovarian tumor [25]. This suggests that the routine appendectomy should be performed as part of the standard staging procedure, at least in mucinous and/or poorly differentiated tumors.…”

Section: Complementary Surgerymentioning

confidence: 99%

Surgical staging of early invasive epithelial ovarian tumors

Leblanc¹,

Querleu²,

Narducci³

et al. 2000

Semin. Surg. Oncol.

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Early stage epithelial ovarian carcinoma is defined pathologically as a tumor strictly limited to one or both ovaries without any extra‐ovarian disease (i.e., Stage IA or B of the International Federation of Gynecology and Obstetrics (FIGO) classification). This diagnosis can be obtained only after an exhaustive surgical staging procedure, performed as soon as the diagnosis of epithelial invasive ovarian carcinoma is established. This staging surgery currently encompasses a peritoneal cytology, the thorough inspection of all the visceral and parietal peritoneal surfaces with biopsy of any abnormality, total abdominal hysterectomy and bilateral salpingo‐oophorectomy (TAH + BSO), random peritoneal biopsies, omentectomy, appendectomy and bilateral pelvic and para‐aortic lymphadenectomies, up to the left renal vein. The results of this staging procedure and its indications are discussed. In all of the cases, the radical removal of the pathologic adnexa is indicated, along with the complete peritoneal and retroperitoneal staging. While fertility‐sparing surgery (avoiding hysterectomy and contralateral adnexectomy, if possible) seems to be safe for young women, a TAH + BSO is the rule for the others. Adjuvant chemotherapy can be omitted in well‐differentiated tumors with a negative staging operation, but currently it remains indicated in all other cases. Indeed, the ultimate goal in early stage ovarian carcinoma is to not impair by inadequate management the high chance of a cure. Semin. Surg. Oncol. 19:36–41, 2000. © 2000 Wiley‐Liss, Inc.

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Section: Complementary Surgerymentioning

confidence: 99%

Surgical staging of early invasive epithelial ovarian tumors

Leblanc¹,

Querleu²,

Narducci³

et al. 2000

Semin. Surg. Oncol.

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“…Although the results of this study were consistent with earlier series, the authors recommended routinely removing the appendix owing to the low morbidity rate related to appendectomy. Subsequently, the authors reported a case with isolated microscopic appendiceal involvement in a patient with clinical early-stage EOC ( 10 ). The second study that recommended the routine removal of the appendix was published by Ayhan et al ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for appendiceal involvement in women with epithelial ovarian cancer

Sarı¹,

Korkmaz²,

Öz³

et al. 2017

J Turkish German Gynecol Assoc

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Objective:To evaluate the risk factors for appendiceal involvement in women with epithelial ovarian cancer (EOC) who underwent appendectomy at the time of initial surgery.Material and Methods:Patients with a final diagnosis of EOC who underwent appendectomy at the time of initial surgery were evaluated retrospectively. Risk factors related to the presence of appendiceal involvement were analyzed.Results:A total of 210 patients underwent appendectomy during staging surgery. Appendiceal involvement was detected in 61 patients. No women with apparent clinical early-stage tumors had evidence of isolated metastatic disease to the appendix; therefore, no upstaging was detected due to solitary appendiceal involvement in this group of patients. For all patients, univariate analysis of the appendiceal involvement revealed age, stage, grade, extragenital organ involvement (omentum, bowel, peritoneum), positive cytology, and lymph node metastasis as significant factors (p<0.05). In the multivariate analysis, appendiceal involvement was significantly affected by age and omental involvement. Older age (>50 years) [odds ratio (OR) 2.8; 95% confidence interval (CI): (1.24-6.37); p=0.014] and presence of omental involvement [OR: 3.2; 95% CI: (1.22-8.59); p=0.018) seemed to be independent risk factors for appendiceal involvement in women with EOC.Conclusion:Our findings indicate that routine appendectomy at the time of surgery for apparent early-stage EOC is not warranted. Nevertheless, the surgeon can take the initiative in regards to performing appendectomy because the morbidity rates due to this procedure are negligible. Older age (>50 years) and presence of omental involvement seem to increase the risk of appendiceal involvement by 2.8 and 3.2 times, respectively.

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“…This is supported by the observations that 14.6 percent of CRC had positive cytology for cancer cells on the peritoneal or perirectal surface of the bowel, particularly in those with extensive lymphatic involvement, poorly differentiated tumors, or liver metastases [ 16 ]. Metastasis to the appendix has been reported in both gastrointestinal and non-gastrointestinal malignancies such as gastric [ 17 ], pancreatic [ 18 ], ovarian [ 5 , 19 ], cervical [ 20 ], nasopharyngeal [ 21 ], breast [ 22 ], and lung [ 23 ].…”

Section: Discussionmentioning

confidence: 99%