Factors Predicting Incidentally Found Appendiceal Tumors Following Appendectomy: Propensity Score Matching Analysis

Area of Science:

• Gastroenterology
• Surgical Pathology
• Oncology

Background:

• Appendiceal neoplasms are rare and often incidentally discovered during appendectomy for appendicitis.
• Early detection and accurate diagnosis are essential for appropriate patient management.

Purpose of the Study:

• To identify predictive factors for coincidental appendiceal neoplasms in patients undergoing appendectomy for appendicitis.
• To develop a model for improved suspicion of appendiceal neoplasia.

Main Methods:

• Retrospective analysis of 5829 patients who underwent appendectomy for appendicitis.
• Propensity score matching analysis to compare patients with appendiceal neoplasia (n=74) and benign pathology (n=274).
• Evaluation of clinical and imaging parameters, including appendix diameter, wall enhancement, and neutrophil count.

Main Results:

• Appendix diameter, lack of contrast enhancement in the appendix wall, and elevated neutrophil count were independently associated with appendiceal neoplasia.
• The combination of these factors achieved an AUC of 0.787 in distinguishing appendiceal neoplasia.
• Mean age was comparable between the neoplasia and benign pathology groups (45.6 vs 46.4 years).

Conclusions:

• Appendix diameter, lack of wall enhancement, and neutrophil count are valuable predictive indicators for appendiceal neoplasms.
• These factors can assist clinicians in suspecting appendiceal neoplasms during the diagnostic workup for appendicitis.
• Further research may validate these findings and integrate them into clinical decision-making tools.