Outcomes in pediatric appendiceal tumors: A national cancer database analysis

To characterize short term clinical outcomes among pediatric patients with appendiceal neoplasms.

The National Cancer Database was queried for pediatric patients 0-17 years of age diagnosed with appendiceal tumors for 2004-2023. We analyzed demographic characteristics as well as short-term outcomes, tumor characteristics, and short-term outcomes. Patients were divided into AJCC stage, histology groups, and surgical approach for further subgroup analysis. All univariate statistical analysis was performed using GraphPad Prism 11 (GraphPad, La Jolla, CA, USA).

Pediatric appendiceal tumors are rare in the United States and often found incidentally on appendectomy, with an estimated annual incidence rate of 0.12% from 2004 to 2023. Patients with pediatric appendiceal neoplasms are more likely to be female, White, non-Hispanic, have private insurance, and live in high median household income areas. Most patients had neuroendocrine tumors that were well differentiated. Most patients underwent surgery, most commonly appendectomy followed by hemicolectomy. Advanced stage tumors, and more invasive surgery (hemicolectomy/partial colectomy) were all associated with prolonged hospital length of stay after surgery with very low overall mortality rates.

Pediatric appendiceal tumors are predominantly early-stage neuroendocrine neoplasms. Advanced stage, non-neuroendocrine histology, and more invasive surgery are associated with longer hospital length of stay and higher readmission rates, but no increased risk for mortality. Further studies are needed to optimize management and follow up for pediatric appendiceal neoplasms.