Increased risk of mucinous neoplasm of the appendix in adults undergoing interval appendectomy
Department of Surgery
Medical Subject Headings
Adenocarcinoma, Mucinous; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; *Appendectomy; Appendiceal Neoplasms; Appendicitis; Carcinoid Tumor; Cystadenoma, Mucinous; Female; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Risk Factors; Young Adult
Digestive System Diseases | Neoplasms | Oncology | Surgery
IMPORTANCE: The role of interval appendectomy after conservative management of perforated appendicitis remains controversial. Determining the etiology of perforated appendicitis is one reason to perform interval appendectomies.
OBJECTIVE: To determine whether adult patients undergoing interval appendectomy experience an increased rate of neoplasms.
DESIGN: Retrospective study.
SETTING: A single tertiary care institution.
PARTICIPANTS: All patients 18 years or older who underwent appendectomy for presumed appendicitis from January 1, 2006, through December 31, 2010.
EXPOSURES Appendectomy for presumed appendicitis.
MAIN OUTCOMES AND MEASURES: Underlying neoplasm as the cause of presentation for presumed appendicitis. Demographic data, clinicopathologic characteristics, interval resection rate, and complication data were collected and analyzed.
RESULTS: During the study period, 376 patients underwent appendectomies. Interval appendectomy was performed in 17 patients (4.5%). Neoplasms were identified in 14 patients (3.7%); 5 of those tumors occurred in patients who had undergone interval appendectomy (29.4%). Nine neoplasms were mucinous tumors (64.3%), including all neoplasms associated with interval appendectomies. The mean age of all patients with appendiceal tumors was 49 years (range, 35-74 years).
CONCLUSIONS AND RELEVANCE: Mucinous neoplasms of the appendix were found in 5 of 17 patients (29.4%) undergoing interval appendectomy. Interval appendectomies should be considered in all adult patients, especially those 40 years or older, to determine the underlying cause of appendicitis. A multi-institutional study to determine the generalizability of these findings is warranted.
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Citation: JAMA Surg. 2013 Aug;148(8):703-6. doi: 10.1001/jamasurg.2013.1212. Link to article on publisher's site
Furman, Matthew J.; Cahan, Mitchell A.; Cohen, Philip; and Lambert, Laura A., "Increased risk of mucinous neoplasm of the appendix in adults undergoing interval appendectomy" (2013). University of Massachusetts Medical School Faculty Publications. 537.