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Carcinoid tumors of the appendix: a population-based study
John T Mullen1, Diane M F Savarese
1Division of Surgical Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA. jmullen@partners.org
Journal of Surgical Oncology
|February 5, 2011
Summary
Appendiceal carcinoid tumors larger than 1.0 cm have a high incidence of lymph node metastases. Right hemicolectomy is recommended for these tumors to improve patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Appendiceal carcinoid tumors are rare.
- Limited data exist on optimal treatment strategies.
Purpose of the Study:
- To identify clinicopathologic factors predicting lymph node involvement and survival in appendiceal carcinoid tumors.
- To guide treatment decisions for these rare tumors.
Main Methods:
- Analysis of patients with malignant, typical carcinoid tumor of the appendix from the Surveillance, Epidemiology, and End Results database (1988-2003).
- Determination of clinicopathologic factors associated with lymph node (LN) metastasis and patient survival.
Main Results:
- Lymph node metastases were present in 49% of patients.
- Tumor size was a significant predictor of lymph node involvement (49% for tumors >1.0 cm but ≤2.0 cm, 86% for tumors >2.0 cm).
- 10-year overall survival rates varied by tumor size and lymph node status, with positive LNs and larger tumors showing reduced survival.
Conclusions:
- Right hemicolectomy should be considered for appendiceal carcinoid tumors >1.0 cm due to high rates of lymph node metastasis.
- Further data are needed on the natural history of unresected lymph node metastases.
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