Long-term Results of Low Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Analysis of 24 Patients

Abstract

Background: Appendix tumors are rare tumors found in the gastrointestinal tract, observed at a rate of about 0.2%–0.3%. Our aim in this study was to present the clinicopathological classification, treatment and long-term prognosis of patients with low grade appendiceal mucinous neoplasm (LAMN). Methods: Patients who underwent surgery in the Erciyes University Department of (Kayseri, Turkey), Department of General Surgery between December 2010 and December 2018, and who had LAMN as a result of pathology were included in our study. Demographic data, clinical and pathological features of the disease, their treatment and follow-up results after treatment were reviewed retrospectively. Results: We included 24 patients in the study. Of these patients, 10 (41.6%) were male. The mean age distribution was 56.4 ± 20.3 (21–91) years. Appendectomy was performed in 14 patients, and additional organ resections were performed in 8 patients. The most common symptom at the time of presentation was abdominal pain (79.1%; 95% CI, 58.3–91.7). The most common preliminary diagnosis in the preoperative period was acute appendicitis (50%; 95% CI, 29.2–70.8). Mean postoperative hospitalization time was 7.4 ± 7.96 (2–31) days. On pathological examination, appendectomy resection margins were positive in two patients. The mean (median) postoperative follow-up was 31.25 ± 23.9 (27) (1–90) months. One-year survival was 91.6%, and 5-year survival was 83.3%. Recurrence was detected in three patients during the follow-up period. Conclusion: If appendix mucinous neoplasia (AMN) is suspected in patients undergoing surgery with an initial diagnosis of acute or plastron appendicitis, care should be taken to remove the lesion without perforation. Pseudomyxoma peritonei, which may develop as a result of perforation, is associated with recurrence and decreased survival.

Großer zystischer Abdominaltumor bedingt durch eine niedrig maligne Neoplasie der Appendix

“…Tumoren der Appendix sind sehr seltene Tumoren des gastrointestinalen Trakts mit einer Häufigkeit von 0,2-0,3 % bzw. < 1 % aller Appendektomien und umfassen das gesamte Spektrum von benignen, niedrig malignen bis hin zu malignen Tumoren [4,5]. Muzinöse Neoplasien der Appendix (AMN) sind sehr seltene Tumoren [6].…”

Long term survival outcomes of surgery combined with hyperthermic intraperitoneal chemotherapy for perforated low‐grade appendiceal mucinous neoplasms: A multicenter retrospective study

“…Although, we tried to minimize the flaws of the study as much as possible but still unavoidable. (1) This study is retrospective. This inherent limitation may have led to selection bias.…”

“…Appendiceal tumors are very rare, accounting for about 0.2%–0.5% of gastrointestinal tumors, 1–3 and most of them were found incidentally during pathological analysis after appendectomy, making up about 0.2%–1% of the pathological specimens after appendectomy 2–4 . According to the 2015 Peritoneal Surface Oncology Organization International (PSOGI) classification, appendiceal epithelial neoplasia is classified as low‐grade appendiceal mucinous neoplasm (LAMN), high‐grade appendiceal mucinous neoplasm, serrated polyp, adenoma, adenocarcinoma, mucinous adenocarcinoma, and hypofractionated adenocarcinoma with indolent cells 5 …”