Predicting appendiceal tumors among patients with appendicitis.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Diagnostic Imaging

Background:

• Nonoperative management of appendicitis is increasingly common.
• Vigilance for underlying appendiceal tumors is crucial.
• Tumors may present atypically within appendicitis cases.

Purpose of the Study:

• To identify predictors of appendiceal tumors in patients presenting with acute appendicitis.
• To evaluate risk factors associated with appendiceal neoplasms.

Main Methods:

• Retrospective cohort analysis of 677 adult patients undergoing appendectomy.
• Multivariate logistic regression to predict appendiceal tumor presence.
• Analysis of patient demographics, comorbidities, symptoms, and CT findings.

Main Results:

• 17 patients (2.5%) had appendiceal tumors.
• Predictors included age ≥ 50 (OR 3.6), steroid/immunosuppressant use (OR 12.1), absence of migratory pain (OR 4.7), and phlegmon on CT (OR 7.0).
• The predictive model demonstrated strong performance (AUC 0.860).

Conclusions:

• Patient factors and CT findings can predict underlying appendiceal tumors.
• Consider appendectomy for patients with appendicitis exhibiting risk factors like advanced age, comorbidities, atypical presentation, or phlegmon on CT.
• Early surgical intervention may be necessary for high-risk appendicitis patients.