Related Experiment Video
Updated: Jun 8, 2025
Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
Published on: April 11, 2025
Mixed adenoneuroendocrine carcinomas of the appendix: Is there a survival advantage to right hemicolectomy over
1Department of General Surgery, Huzhou Central Hospital (The Affiliated Central Hospital of Huzhou University, The Fifth School of Clinical Medicine, Zhejiang Chinese Medical University, The Affiliated Huzhou Hospital, Zhejiang University School of Medicine), Huzhou, 313000, China.
Background:
the surgical treatment and prognostic characteristics of mixed adenoneuroendocrine carcinomas (MANEC) of the appendix are not yet available. In this study, we sought to figure out the choice of surgical approach (right hemicolectomy versus appendectomy), and explore the effect of chemotherapy on appendiceal MANEC.
Methods:
patients with appendiceal MANEC from the Surveillance, Epidemiology, and End Results database (2000-2020) were stratified by gender, race, age group, tumor grade, and TNM stage. Logistic regression and Kaplan-Meier analyses relating TNM stage, grade, and receipt of right hemicolectomy (abbreviated as colectomy) to overall and cancer-specific survival were performed.
Results:
455 patients with appendiceal MANEC were included, of whom 146(32 %) underwent appendectomy and 309(68 %) underwent colectomy. Patients who underwent colectomy had better cancer-specific survival (HR = 0.68, 95%CI (0.47-0.98), P = 0.041) and overall survival (HR = 0.67, 95%CI (0.48-0.93), P = 0.015) than those who underwent appendectomy alone. However, colectomy did not confer any survival advantage over appendectomy in subgroup analyses, including low-grade or high-grade tumors, T1-2N0M0 group, T3-4N0M0 group, node-positive non-metastatic tumors, and metastatic tumors. On multivariate analysis, lack of chemotherapy and high-stage (node-positive or metastatic) were associated with poorer overall survival; high-grade (grade 3-4) and high-stage were primary predictors of cancer-specific mortality. Furthermore, there was no significant association between colectomy and better survival, either overall survival or cancer specific survival, when accounting for tumor stage and grade.
Conclusions:
Our study found that colectomy did not provide a survival benefit compared to appendectomy alone. Moreover, tumor stage and grade were independent determinants of cancer specific survival; chemotherapy and tumor stage were independent determinants of overall survival.
Related Concept Videos
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...