Abstract
Purpose: To investigate the long-term prognosis of appendiceal tumours incidentally detected at appendicectomy for suspicion of benign appendicitis.
Methods: A retrospective register-based single centre cohort study was carried out, using data from the local acute appendicectomy quality register of cases operated on at the Department of Surgery, South General Hospital, Stockholm, Sweden. The local colorectal cancer register was also used to identify appendix tumours. The study period was between January 2004 and January 2023. Survival was calculated according to the Kaplan-Meier method.
Results: A total of 11,888 patients were registered in the acute acute appendicectomy register, 54% males and 46% females, and 33.7 % were 41 years or older. From the appendicectomy and colorectal registers 148 (1.2% of the total cohort) appendiceal tumours were found; 60% in females and 40% in males with 78.4% being 41 years or older. Tumours found were: Low grade Appendiceal Mucinous Neoplasms (LAMN, N= 64); Neuroendocrine Tumours (NET N=24); adenocarcinomas or other form of carcinomas (N=57); and adenomas (N=3). For the younger patients (<51 years) with LAMN and NET, almost all survived to the end of follow-up. Survival of patients in the carcinoma group was statistically significantly lower than for the LAMN and NET groups, especially in females 51 years or older.
Conclusion: Survival was high for patients with incidentally detected appendiceal LAMN or NET, but not so for carcinoma. Survival was lower in the carcinoma group older than 50 years, especially those sick and females.