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Malignancies of the appendix: beyond case series reports
Marcia L McGory1, Melinda A Maggard, Hakjung Kang
1Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California 90095-6904, USA. mmcgory@mednet.ucla.edu
Diseases of the Colon and Rectum
|November 1, 2005
Summary
Appendiceal tumors show varied survival and surgical appropriateness. Many patients with noncarcinoid tumors or large carcinoids receive less extensive surgery than recommended, impacting outcomes.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Epidemiology
Background:
- Appendiceal tumors encompass diverse histologic types with varying clinical behaviors.
- Understanding their incidence, characteristics, and treatment is crucial for patient outcomes.
Purpose of the Study:
- To compare incidence, clinicopathologic features, survival, and surgical appropriateness across five main appendiceal tumor histologies.
- To analyze population-based data for appendiceal malignancies.
Main Methods:
- Analysis of Surveillance, Epidemiology, and End Results database (1973-2001) for mucinous adenocarcinoma, adenocarcinoma, carcinoid, goblet, and signet-ring cell tumors.
- Evaluation of tumor incidence, stage, five-year relative survival, and surgical procedure appropriateness (appendectomy vs. colectomy) by tumor type and size.
Main Results:
- Significant variations in incidence, demographics, survival, and surgical appropriateness were observed among appendiceal tumor histologies.
- Carcinoid tumors presented in younger females, with highest survival (83%); signet-ring cell had lowest survival (18%).
- Inappropriate surgical resection was common: 30% of noncarcinoids and 28% of carcinoids >2 cm underwent appendectomy instead of colectomy.
Conclusions:
- This population-based study characterizes appendiceal carcinomas, providing novel insights into presentation and outcomes.
- A significant proportion of patients with appendiceal tumors do not receive the recommended surgical resection, potentially affecting prognosis.