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Appendiceal Tumor Prevalence in Patients With Periappendicular Abscess.
Roosa Salminen1,2, Jenny Alajääski2,3,4, Tero Rautio1
1Oulu University Hospital and Medical Research Center Oulu, University of Oulu, Oulu, Finland.
JAMA Surgery
|April 2, 2025
Summary
Patients with periappendicular abscess have a significantly higher rate of appendiceal tumors. Age over 35 is a key indicator, suggesting routine interval appendectomy for this group.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Clinical Research
Background:
- Periappendiceal abscess is associated with a higher rate of appendiceal tumors, but large prospective data are limited.
- Previous reports suggest a significant tumor burden in patients with periappendiceal abscesses.
Purpose of the Study:
- To confirm the appendiceal neoplasm rate in patients diagnosed with periappendiceal abscess.
- To identify prognostic factors for appendiceal tumors in this cohort.
Main Methods:
- Prospective multicenter cohort study (Peri-Appendicitis Acuta Tumor study) including adult patients with acute appendicitis.
- Focused analysis on patients with imaging-confirmed periappendiceal abscess undergoing appendectomy.
- Histopathological analysis of resected appendices to determine tumor presence and type.
Main Results:
- Appendiceal tumor rate was 14.3% in patients with periappendiceal abscess, significantly higher than uncomplicated (1.5%) or other complicated appendicitis (2.4%).
- Patient age was the sole significant factor associated with tumor prevalence, with a cutoff of 35 years identified.
- Common tumor types included low-grade appendiceal mucinous neoplasms and adenocarcinomas.
Conclusions:
- A high rate of appendiceal tumors is confirmed in patients with periappendiceal abscess.
- Routine interval appendectomy is recommended for patients over 35 years with periappendiceal abscess.
- Early detection and management of appendiceal neoplasms in this patient group are crucial.
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