Role of right hemicolectomy in patients with low-grade appendiceal mucinous adenocarcinoma

Am J Surg. 2019 Dec;218(6):1239-1243. doi: 10.1016/j.amjsurg.2019.07.035. Epub 2019 Jul 25.

Abstract

Background: There is little consensus with regards to the most appropriate surgical management for low-grade appendiceal mucinous adenocarcinomas (LAMA), though right hemicolectomy is usually recommended.

Methods: The SEER database was queried for all patients with non-metastatic LAMA. Disease specific and overall survival was compared by surgery type: 1) appendectomy, 2) formal right hemicolectomy 3) non-formal colectomy (including ileocecectomy).

Results: A total of 579 patients with non-metastatic LAMA were identified. 133 (23%), 404 (70%), and 42 (7%) of patients had stage I, II, and III disease, respectively. 99 (17.1%) had appendectomy, 87 (15%) had non-formal colectomy, and 302 (52.2%) had formal right hemicolectomy. We observed no significant differences in disease specific or overall survival by surgery type. Controlling for age and stage, surgery type was not a significant predictor of disease specific or overall survival.

Conclusion: In patients with localized LAMA, right hemicolectomy did not increase disease specific or overall survival. Right hemicolectomy should be reserved for LAMA patients with positive margins post appendectomy.

Keywords: Appendectomy; Appendiceal adenocarcinoma; Appendiceal neoplasm; Low grade appendiceal mucinous adenocarcinoma; Right hemicolectomy.

MeSH terms

  • Adenocarcinoma, Mucinous / pathology
  • Adenocarcinoma, Mucinous / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Appendectomy
  • Appendiceal Neoplasms / pathology
  • Appendiceal Neoplasms / surgery*
  • Colectomy / methods*
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Margins of Excision
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Patient Selection
  • SEER Program
  • Survival Rate