Comparison between early surgical treatment and conservative treatment of appendicitis in cancer patients

Abstract

AbstractBackgroundsIn cancer patients, the optimal appendicitis treatment has not been established. Therefore, we aimed to determine the ideal treatment option for appendicitis in cancer patients.MethodsThis retrospective study included 185 cancer patients with acute appendicitis who were divided into the early surgical group (n = 152) involving surgery performed within 48 h following the appendicitis diagnosis or the conservative group (n = 33) involving intravenous antibiotics. We compared the appendicitis treatment efficacy between the groups.ResultsIn the early surgical group, the antibiotic duration [5.5 days (4.0–8.0) vs. 17.0 days (12.5–25.0), p < 0.001] and hospital stay length [7.0 days (5.0–11.75) vs. 10.0 days (8.0–32.0), p < 0.001] were significantly shorter. Regarding pathology, 16/171 (9.4%) patients who underwent surgery exhibited appendiceal tumours. During the 1‐year follow‐up period, one recurrence occurred in each group [1/152 (0.7%) vs. 1/33 (3.0%), p = 0.326]. The 1‐year treatment success rate was higher in the early surgical group [99.3% (151/152) vs. 42.4% (14/33), p < 0.001].ConclusionEarly surgical treatment yielded a significantly higher success rate than conservative treatment for appendicitis in cancer patients. Surgery for appendicitis in cancer patients should be considered not only for treatment but also for pathologic confirmation.