Appendix neuroendocrine tumors: A single center experience

Yıl 2023, Cilt: 16 Sayı: 2, 40 - 44, 08.08.2023

Haldun Kar , Erdinç Kamer , Halis Bağ , Cengiz Tavusbay , Emine Özlem Gür , Betül Bolat Küçükzeybek , Mehmet Haciyanli

Öz

Appendiceal neuroendocrine neoplasms (ANENs) comprise approximately 30-80% of appendicular tumors. ANENs are frequently encountered incidental and account for 0.1 percent to 3 percent of appendecto-mies. Well-differentiated ANENs have a favorable prognosis with a 5-year survival rate in almost all patients with local disease. In this study, we evaluated the clinical findings, risk factors, and clinical output data and revealed the most accurate approach in light of the literature.
In this retrospective single-center study, the files of patients who underwent an appendectomy either as appendicitis or as a part of another abdominal surgical procedure histopathological diagnosed with neuroendoc-rine tumors in the last 14 years were entered into the study.
Between January 2009 and January 2023, 5818 patients underwent appendectomy. The pathology of 36 patients (0.61%) was an appendiceal neuroendocrine tumor. Complementary right hemicolectomy was per-formed in 6 (20.6%) patients. Lymph node metastasis and/or residual tumor are not observed. In this group, three of the 4 patients in the gray zone had R1 resection and one had perforated appendicitis. Surgery was re-commended for patients with a tumor diameter of 2 cm, mesoappendix invasion, and a tumor diameter of 2 cm located at the base, but the patients did not accept it. There is no recurrence or metastasis in the patients fol-lowed.
To reduce radical surgical procedures of appendiceal neuroendocrine tumors located in the gray zone, R1 resection, and perforation detected, the operation information and pathology reports of these cases should be evaluated in multidisciplinary tumor boards. High-volume studies with multicenter participation on this sub-ject should be conducted

Anahtar Kelimeler

appendix, neuroendocrine tumors, right hemicolectomy, overtreatment

Kaynakça

• 1. Pawa N, Clift AK, Osmani H, Drymousis P, Cichocki A, Flora R, et al. Surgical Management of Patients with Neuroendocrine Neoplasms of the Appendix: Appendectomy or More. Neuro-endocrinology 2018;106(3):242-251.
• 2. Pape UF, Niederle B, Costa F, Gross D, Kelesti-mur F, Kianmanesh R, et al. ENETS Consensus Guidelines for Neuroendocrine Neoplasms of the Appendix (Excluding Goblet Cell Carcino-mas). Neuroendocrinology 2016;103(2):144-152.
• 3. Moris D, Tsilimigras DI, Vagios S, Ntanasis-Stathopoulos I, Karachaliou GS, Papalampros A, et al. Neuroendocrine Neoplasms of the Ap-pendix: A Review of the Literature. Anticancer Res 2018;38(2):601-611.
• 4. Brighi N, La Rosa S, Rossi G, Grillo F, Pusceddu S, Rinzivillo M, et al. Morphological Factors Re-lated to Nodal Metastases in Neuroendocrine Tumors of the Appendix: A Multicentric Ret-rospective Study. Ann Surg 2020;271(3):527-533.
• 5. Galanopoulos M, McFadyen R, Drami I, Naik R, Evans N, Luong TV, et al. Challenging the Current Risk Factors of Appendiceal Neuroen-docrine Neoplasms: Can They Accurately Pre-dict Local Lymph Nodal Invasion? Results from a Large Case Series. Neuroendocrinology 2019; 109(2):179-186.
• 6. Mohamed A, Wu S, Hamid M, Mahipal A, Cjakrabarti S, Bajor D, et al. Management of Appendix Neuroendocrine Neoplasms: Insights on the Current Guidelines. Cancers (Basel) 2022;15(1): 295.
• 7. Kunz PL, Reidy-Lagunes D, Anthony LB, Berti-no EM, Brendtro K, Chan JA, et al. Consensus guidelines for the management and treatment of neuroendocrine tumors. Pancreas 2013;42(4): 557-577.
• 8. Crown A, Simianu VV, Kennecke H, Lopez-Aguiar AG, Dillhoff M, Beal EW, et al. Appen-diceal Neuroendocrine Tumors: Does Colon Re-section Improve Outcomes? J Gastrointest Surg 2020;24(9):2121-2126.
• 9. Mehrvarz Sarshekeh A, Advani S, Halperin DM, Conrad C, Shen C, Yao JC, et al. Regional lymphnode involvement and outcomes in ap-pendiceal neuroendocrine tumors: a SEER da-tabase analysis. Oncotarget 2017;8(59):99541-99551.
• 10. Khan K, Patil S, Roomi S, Shiwani MH. Appen-dicular Neuroendocrine Neoplasm is Associated with Acute Appendicitis- Don't Miss the Boat. Chirurgia (Bucur) 2019;114(4):461-466.
• 11. Yavuz Y, Şentürk M. 25 Carcinoid Tumor Ca-ses Incidentally Detected After 4642 Appendec-tomies.Turk J Colorectal Dis2020;30:21-26.
• 12. Zhang HW, Jiang Y, Huang ZY, Zhou XC. Analysis of surgical treatment of appendix neu-roendocrine neoplasms - 17 years of single-center experience. World J Surg Oncol 2023; 21(1):150.
• 13. Gumuşoglu AY, Donmez T, Kabuli HA, Onur ND, Ferahman S, Sakiz D, et al. Management of appendiceal neuroendocrine tumors in the light of newguidelines. Ir J Med Sci 2022;191(3): 1133-1137.
• 14. Eğin S, Kamalı G, Kamalı S, Gökçek B, Yeşiltaş M, Hot S, et al. Neuroendocrine tumor of the appendix: Twelve years of results from a single institution. Ulus Travma Acil Cerrahi Derg 2019;25(2):118-122.
• 15. Kunduz E, Bektasoglu HK, Unver N, Aydogan C, Timocin G, Destek S. Analysis of Appendi-ceal Neoplasms on 3544 Appendectomy Spe-cimens for AcuteAppendicitis: Retrospective Cohort Study of a Single Institution. Med Sci Monit 2018;24:4421-4426.
• 16. Walter T, Rault-Petit B, Scoazec JY. Response to Comment on "Current Management and Predictive Factors of LymphNode Metastasis of Appendix Neuroendocrine Tumors: A National Study From the French Group of Endocrine Tumors (GTE)". Ann Surg 2019;270(2):e44-e46.
• 17. Davenport E, Courtney ED, Benson-Cooper S, Bissett IP. Appendiceal neuroendocrine neop-lasm in the era of laparoscopic appendi-cectomy. ANZ J Surg 2014;84:337-340.
• 18. Holmager P, Willemoe GL, Nielsen K, Grøndahl V, Klose M, Andreassen M, et al. Neuroendocri-ne neoplasms of the appendix: Characteriza-tion of 335 patients referred to the Copenhagen NET Center of Excellence. Eur J SurgOncol 2021; 47(6):1357-1363.
• 19. McCann C, Schwartz J, Perry L, Cheng E. Perfo-rated Carcinoid Tumor of the Appendix: Need for Guidelines for Management With Respect to Prognostic Factors. Am Surg 2021;31: 34820960027.
• 20. Twito O, Paran H, Avital S, Kravtsov V, Ro-senblum RC, Rotman-Pikielny P, et al. Tempo-ral trends in incidence, evaluation and mana-gement of neuroendocrine neoplasms of the appendix: 14 years' experience. Am J Surg 2021;221(5):1000-1004.