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

Park, Sin Hye; Lee, Dong Woon; Park, Hyoung-Chul; Park, Sung Chan; Hong, Chang Won; Sohn, Dae Kyung; Han, Kyung Su; Chang, Hee Jin; Oh, Jae Hwan

doi:10.1111/ans.17180

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…With this in mind, cancer patients are typically considered poor surgical candidates due to the clinical complexity of their underlying cancer as well as other comorbid conditions. Limited studies have shown that both nonsurgical management and early appendectomy are suitable strategies for cancer patients (Park et al, 2021;Santos et al, 2016). Within our cohort of post-ICI therapy appendicitis patients, nonsurgical management with antibiotics or IR drainage was employed more often than was surgical intervention.…”

Section: Characteristics Of Patients With Appendicitis-related Compli...mentioning

confidence: 99%

Characteristics of appendicitis after immune checkpoint inhibitor therapy among cancer patients

Mathew

Shatila

Lai

et al. 2022

J Cancer Res Clin Oncol

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Immune checkpoint inhibitor (ICI) therapy has revolutionized cancer care but is associated with immune-related adverse events (irAEs). Recent case reports raised the concern that acute appendicitis may be an irAE. In this study, we sought to describe the disease course of post-ICI therapy appendicitis and its associated complications. MethodsAdult patients who had an International Classi cation of Diseases code for appendicitis within the rst 2 years after initiating ICI therapy from January 2010 to April 2021 and who had imaging evidence of appendicitis were studied retrospectively. Results13,991 patients were identi ed who had ICI exposure during the study period, 44 had codes for appendicitis, 10 of whom met the inclusion criteria. Their median age at the time of diagnosis was 59 years. The median time from ICI therapy initiation to appendicitis onset was 188 days. The most common presenting symptoms were abdominal pain (70%) and fever (40%).Abscesses were present in two patients, and a perforation was present in one. All 10 patients received broad-spectrum antibiotics. Five patients needed surgery or interventional radiology drainage. Nine patients had resolution of appendicitis symptoms after treatment. ConclusionPost-ICI therapy appendicitis is rare but presents similarly to and has similar complications rates as conventional appendicitis. Appendectomy remains the mainstay of treatment, but its use can be limited in cancer patients. The decision to continue ICI therapy remains at the discretion of the clinician. Further studies are needed to bring awareness to and advance the understanding of this clinical entity.

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Section: Characteristics Of Patients With Appendicitis-related Compli...mentioning

confidence: 99%

Characteristics of appendicitis after immune checkpoint inhibitor therapy among cancer patients

Mathew

Shatila

Lai

et al. 2022

J Cancer Res Clin Oncol

View full text Add to dashboard Cite

show abstract

Characteristics of Appendicitis after Immune Checkpoint Inhibitor Therapy among Cancer Patients

Mathew

Shatila

Lai

et al. 2022

Preprint

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PurposeImmune checkpoint inhibitor (ICI) therapy has revolutionized cancer care but is associated with immune-related adverse events (irAEs). Recent case reports raised the concern that acute appendicitis may be an irAE. In this study, we sought to describe the disease course of post-ICI therapy appendicitis and its associated complications.Methods Adult patients who had an International Classification of Diseases code for appendicitis within the first 2 years after initiating ICI therapy from January 2010 to April 2021 and who had imaging evidence of appendicitis were studied retrospectively. Results 13,991 patients were identified who had ICI exposure during the study period, 44 had codes for appendicitis, 10 of whom met the inclusion criteria. Their median age at the time of diagnosis was 59 years. The median time from ICI therapy initiation to appendicitis onset was 188 days. The most common presenting symptoms were abdominal pain (70%) and fever (40%). Abscesses were present in two patients, and a perforation was present in one. All 10 patients received broad-spectrum antibiotics. Five patients needed surgery or interventional radiology drainage. Nine patients had resolution of appendicitis symptoms after treatment. ConclusionPost-ICI therapy appendicitis is rare but presents similarly to and has similar complications rates as conventional appendicitis. Appendectomy remains the mainstay of treatment, but its use can be limited in cancer patients. The decision to continue ICI therapy remains at the discretion of the clinician. Further studies are needed to bring awareness to and advance the understanding of this clinical entity.

show abstract

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

Cited by 2 publications

References 22 publications

Characteristics of appendicitis after immune checkpoint inhibitor therapy among cancer patients

Characteristics of appendicitis after immune checkpoint inhibitor therapy among cancer patients

Characteristics of Appendicitis after Immune Checkpoint Inhibitor Therapy among Cancer Patients

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