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

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. The SEER database was queried for all patients with non-metastatic LAMA. Disease specific and overall survi...

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Bibliographic Details
Published in:The American journal of surgery 2019-12, Vol.218 (6), p.1239-1243
Main Authors: Nasseri, Yosef Y., Zhu, Ruoyan, Sutanto, Christine, Wai, Christina, Cohen, Jason S., Ellenhorn, Joshua, Artinyan, Avo
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adenocarcinoma, Mucinous - pathology
Adenocarcinoma, Mucinous - surgery
Adult
Age
Aged
Aged, 80 and over
Appendectomy
Appendiceal adenocarcinoma
Appendiceal neoplasm
Appendiceal Neoplasms - pathology
Appendiceal Neoplasms - surgery
Appendix
Cancer
Cellular biology
Codes
Colectomy - methods
Disease control
Female
Gastrointestinal cancer
Humans
Low grade appendiceal mucinous adenocarcinoma
Lymphatic Metastasis
Lymphatic system
Male
Margins of Excision
Metastases
Metastasis
Middle Aged
Neoplasm Grading
Neoplasm Staging
Patient Selection
Regression analysis
Right hemicolectomy
SEER Program
Surgery
Survival
Survival analysis
Survival Rate
Tumors
Variables
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Summary: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. 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). 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. 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. •Currently, most patients with low grade appendiceal adenocarcinoma (LAMA) undergo right colectomy.•Overall, the rate of lymph node spread is found to be 7.3% for LAMA.•Surgery type (i.e. appendectomy or right colectomy) was not a predictor of either disease specific or overall survival.•Right hemicolectomy did not increase disease specific or overall survival.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2019.07.035