The American Society of Colon and Rectal Surgeons, Clinical Practice Guidelines for the Management of Appendiceal Neoplasms

Integrated clinico-molecular profiling of appendiceal adenocarcinoma reveals a unique grade-driven entity distinct from colorectal cancer

“…34 Additionally, new guidelines from the American Society of Colon & Rectal Surgeons now suggest avoiding chemotherapy for low-grade AA. 35 Treatment modalities for AAs include CRS and HIPEC for surgically resectable disease and systemic therapy for unresectable cases. [36][37][38][39] Systemic therapy used for AA patients in our cohort was similar to that for CRC patients, with most getting treated with 5-FU combinations with either oxaliplatin (FOLFOX) or irinotecan (FOLFIRI) with the addition of either an anti-EGFR, or anti-VEGF biological agent, which reflects current NCCN guidelines in CRC.…”

“… 34 Additionally, new guidelines from the American Society of Colon & Rectal Surgeons now suggest avoiding chemotherapy for low-grade AA. 35 …”

Giant mucocele of the appendix – laparoscopic management: A case report and review of the literature

“…Lymph node metastasis secondary to mucinous appendiceal neoplasm is rare and accounts for 4.2% of patients with mucinous malignancy [13]. Mucocele of the appendix also has an association with other intra-abdominal neoplasms, especially carcinoma of the colon (13-42%) and the tumors of the ovary [14]. Patients with the WHO type D mucoceles should be enrolled in a systematic surveillance program and followed up with serial CECT scans and monitoring of tumor marker levels (CEA, CA 19-9, CA 125, CA 15-3, and CA 72-4) for 5-10 years, for early pick up of possible recurrent disease.…”

Appendiceal mucocele: three cases with different clinical presentation and review of literature

“…− Completely resected LAMN or HAMN : if the lesion is a LAMN confined to the appendix, has not ruptured, and is completely resected by appendectomy do not require a completion right hemicolectomy [ 7 ]. In clinical cases with positive margins, there is not a unique indication, as some authors propose a completion right hemicolectomy and lymphadenectomy [ 7 ], whereas other authors confirm that it is not always necessary, since limited data suggest that a positive margin following appendectomy for unruptured LAMN does not predict disease recurrence [ 8 ]. Appendectomy alone is usually sufficient for treating HAMN limited to the appendix, but care should be taken to exclude the presence of associated invasive adenocarcinoma, including comprehensive histologic evaluation of the entire surgical specimen [ 8 ].…”

“…In clinical cases with positive margins, there is not a unique indication, as some authors propose a completion right hemicolectomy and lymphadenectomy [ 7 ], whereas other authors confirm that it is not always necessary, since limited data suggest that a positive margin following appendectomy for unruptured LAMN does not predict disease recurrence [ 8 ]. Appendectomy alone is usually sufficient for treating HAMN limited to the appendix, but care should be taken to exclude the presence of associated invasive adenocarcinoma, including comprehensive histologic evaluation of the entire surgical specimen [ 8 ]. Patients who are found to have peritoneal mucin at the time of initial surgery should be referred to a centre specialized in the treatment of peritoneal surface malignancies [ 5 ].…”