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A scoping review of postoperative surveillance strategies for localized, low-grade appendiceal mucinous neoplasms
Nebojša Oravec1, Lloyd Mack1, Dara Hallock2
1Department of Surgery, University of Calgary Cumming School of Medicine, Calgary, Canada, T2N 1N4.
Introduction:
There is a paucity of data to support surveillance protocols for localized, low-grade appendiceal mucinous neoplasms (LAMNs) after resection.
Methods:
A search strategy was developed to identify postoperative surveillance strategies for LAMNs, in the context of rates of recurrence and disease-free survival, and applied to four literature databases. Resultant citations were subject to screening in duplicate, in three stages: title, abstract, and full-text. Data was extracted from the final set of included articles and subject to descriptive statistics.
Results:
A total of 16 articles, representing 1218 patients, were included. The duration of surveillance ranged from 0.1 to 294 months, and the mode surveillance interval was three months. The most common surveillance method was imaging (n = 610 patients, 48.7 %). Thirty one patients had disease recurrence (2.7 %). Time to recurrence ranged from 2.5 to 68 months, and the range of five-year survival was 93.5-95.2 % among five studies.
Discussion:
In the absence of strong evidence to suggest that surveillance confers a survival benefit for patients with localized LAMNs after resection, decisions about surveillance should be patient-oriented.
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