Appendiceal neoplasm risk associated with complicated acute appendicitis-a population based study

Area of Science:

• Gastroenterology
• Surgical Oncology
• Epidemiology

Background:

• Appendiceal tumors are uncommon but noted with increased frequency in interval appendectomies post-abscess.
• Non-operative management for uncomplicated acute appendicitis shows promise.
• Limited data exists on appendiceal tumor incidence in acute appendicitis, particularly differentiating complicated vs. uncomplicated cases.

Purpose of the Study:

• To determine appendiceal tumor incidence in patients diagnosed with acute appendicitis.
• To investigate the association between appendiceal tumors and both uncomplicated and complicated acute appendicitis.

Main Methods:

• A nationwide population-based registry study was conducted from 2007 to 2013 in Finland.
• Data from the Finnish Cancer Registry and National Institute for Health Registry were combined with medical reports from eight hospitals.
• All appendiceal tumors and acute appendicitis diagnoses were analyzed.

Main Results:

• Out of 840 identified appendiceal tumors, 472 patients were included in the study.
• Appendiceal tumors were diagnosed during appendectomy for suspected acute appendicitis in 58% of cases.
• Histologically, 53% of patients had both appendicitis and a tumor; 41% of these had complicated appendicitis and 59% had uncomplicated appendicitis.
• The tumor risk was significantly higher in complicated appendicitis (3.24%) versus uncomplicated appendicitis (0.87%).
• Overall appendiceal tumor prevalence in acute appendicitis patients was 1.24%.

Conclusions:

• Appendiceal tumor prevalence is low among patients with acute appendicitis.
• Complicated acute appendicitis presents a significantly higher risk for associated appendiceal tumors compared to uncomplicated cases.
• The risk of missing appendiceal tumors due to antibiotic treatment for uncomplicated appendicitis is minimal.