Carcinoid tumors of the appendix

The data presented in this series support the premise that simple appendectomy is adequate therapy for appendiceal carcinoids less than 1 cm in diameter. However, little argument can be made against more radical surgery for gross lymph node metastases. When surgical margins after appendectomy are not free of tumor, additional surgery seems warranted, although in the present series there was a patient who was followed for 30 years who had residual microscopic disease in the appendiceal stump. Adequate treatment for tumors larger than 2 cm includes radical right hemicolectomy. What constitutes adequate therapy for tumors in the 1 to 2 cm range continues to be a point of controversy. From the data presented herein, it seems that appendectomy alone is sufficient except in those instances when both mesoappendiceal and subserosal lymphatic invasion is identified microscopically.