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

Nasseri, Yosef; Zhu, Ruoyan; Sutanto, Christine; Wai, Christina; Cohen, Jason; Ellenhorn, Joshua D. I.; Artinyan, Avo

doi:10.1016/j.amjsurg.2019.07.035

Cited by 18 publications

(12 citation statements)

References 12 publications

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“…The specimen should be promptly positioned in an endobag for further exploration and extraction in order to avoid peritoneal dissemination. The surgeon should have a low threshold to convert to open surgery in case complete resection cannot by achieved by laparoscopy or in case of suspected extra organ local involvement [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Appendiceal mucocele: three cases with different clinical presentation and review of literature

Cestino

Festa

Cavuoti

et al. 2020

Journal of Surgical Case Reports

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Mucinous lesions of appendix are a rare clinical entity and may be neoplastic or non-neoplastic. The diagnosis is usual incidental during computed tomography scan or colonoscopy performed for general abdominal symptoms or occasional finding during operation for acute appendicitis. For this reason, initial treatment should be tailored to the situation, aiming at complete resection of the appendix with disease-free margins: this can be achieved by simple appendectomy or more extensive resection. The pathological examination of the specimen is the key to offer the patient a correct and complete treatment, and, if a neoplastic pathology is found, the case should be discussed in multidisciplinary group. We describe three cases with different clinical presentation leading to different surgical treatment: one elective case, in which the diagnosis was suspected preoperatively; and two urgent cases, one mimicking an intussusception and another one presenting as an acute appendicitis.

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Section: Discussionmentioning

confidence: 99%

“…However, Nasseri et al. [ 9 ], in a retrospective study, demonstrated that the addition of right hemicolectomy in patients with margin negative appendectomy does not offer a survival benefit in patients with non-metastatic, low-grade appendiceal mucinous adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

Appendiceal mucocele: three cases with different clinical presentation and review of literature

Cestino

Festa

Cavuoti

et al. 2020

Journal of Surgical Case Reports

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“…Well and moderately differentiated tumours without LVI have an incidence of lymph node metastasis of 5% and 6% respectively 21 . Two large population studies with over 1500 patients with well‐differentiated appendiceal adenocarcinomas failed to demonstrate any survival advantage of a right hemicolectomy over an appendectomy in these patients 22,23 . Although a right hemicolectomy remains the standard of care, these retrospective studies suggest that patients with well‐differentiated appendiceal adenocarcinomas without LVI and with negative margins can be effectively managed by a radical appendectomy.…”

Section: Management Of Specific Clinical Scenarios and Histologic Finmentioning

confidence: 99%

“…21 Two large population studies with over 1500 patients with welldifferentiated appendiceal adenocarcinomas failed to demonstrate any survival advantage of a right hemicolectomy over an appendectomy in these patients. 22,23 Although a right hemicolectomy remains the standard of care, these retrospective studies suggest that patients with welldifferentiated appendiceal adenocarcinomas without LVI and with negative margins can be effectively managed by a radical appendectomy. Even without preoperative evidence of disease, appendiceal adenocarcinomas are much more likely to spread to the peritoneum (57%) than in the lymph nodes (15%).…”

Section: Mucinous Appendiceal Adenocarcinomamentioning

confidence: 99%

Mucinous appendiceal neoplasms with or without pseudomyxoma peritonei: a review

Soucisse

Lansom

Alshahrani

et al. 2020

ANZ Journal of Surgery

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Mucinous appendiceal neoplasms (MANs) are rare tumours and the primary cause of pseudomyxoma peritonei. These tumours have a much more benign course than typical colorectal cancers, generally growing for many years before giving any clinical signs. The spectrum of presentations, tumour stages and the underlying cytology is very wide, warranting from the simplest operation like an appendicectomy to the most complicated operation like a complete cytoreduction surgery and hyperthermic intraperitoneal chemotherapy. Fortunately, most patients can be offered a curative treatment, but limiting operative morbidity without compromising oncologic outcomes is the biggest challenge in managing these patients. Histopathology is the cornerstone of decision making for MANs, but is also subject to ongoing debate because of a lack of terminology consensus amongst pathologists. Combined with the rarity of this disease, the multiple histopathologic classification updates of MANs explain the ongoing confusion amongst clinicians in regard to individual optimal treatment. This review will cover the most recent histological classification of MANs and attempt to clarify optimal management of patients with different clinical presentation and histologic combinations.

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“…In appendiceal mucocele, preoperative detection of a neoplasm should be done if possible for the sake of surgical planning. Appendectomy is sufficient for simple mucocele, serrated polyps, unruptured low-or highgrade appendiceal mucinous neoplasms, and a well-differentiated mucinous adenocarcinoma of the appendix without rupture [10]. By contrast, ileocaecal resection or right hemicolectomy with lymph node dissection is generally warranted for moderately to poorly differentiated mucinous adenocarcinoma [11][12][13][14] since it was reported that the 10-year survival rate among patients with mucinous adenocarcinoma was 65% for those treated with hemicolectomy and only 37% for those who underwent appendectomy alone [15].…”

Section: Introductionmentioning

confidence: 99%

Utility of computed tomography and ¹⁸F‐fluorodeoxyglucose with positron emission tomography/computed tomography for distinguishing appendiceal mucocele caused by mucinous adenocarcinoma from other pathologies

et al. 2020

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Aim Differentiating appendiceal mucocele with mucinous adenocarcinoma from other pathologies before surgery is difficult. The objective of this study was to evaluate the utility of CT and 18 F-fluorodeoxyglucose (FDG) with positron emission tomography (PET)/CT for differentiating mucinous adenocarcinoma of appendiceal mucocele from other pathologies. Method The study included 25 patients who underwent surgery for clinically diagnosed appendiceal mucoceles detected on CT at the University of Tokyo Hospital. Among these patients, 19 underwent FDG-PET/CT preoperatively. We compared features of the CT imaging findings and maximum standard uptake values (SUV max) detected by FDG-PET/CT between mucocele with mucinous adenocarcinoma and other pathologies. Results A total of 13 men (52%) and 12 women (48%) were included in this study, with a median age of 65 years (range 34-83). There were six patients (24%) with pathologically confirmed mucinous adenocarcinoma, 15 patients (60%) with appendiceal mucinous neoplasm and four patients (16%) with simple mucocele caused by chronic inflammation. On the CT findings, wall irregularity was the only significant feature for the two groups in this study (83.3% vs 0.0%, P < 0.01). There was a significant difference in the SUV max levels on PET/CT between the two groups (100.0% vs 20.0%, P < 0.01). Conclusion Distinguishing between mucocele with mucinous adenocarcinoma and other pathologies using imaging modalities is challenging. Our results suggest that wall irregularity on CT and elevated SUV max on PET/CT are useful factors that can be employed for such discrimination.

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

Cited by 18 publications

References 12 publications

Appendiceal mucocele: three cases with different clinical presentation and review of literature

Appendiceal mucocele: three cases with different clinical presentation and review of literature

Mucinous appendiceal neoplasms with or without pseudomyxoma peritonei: a review

Utility of computed tomography and ¹⁸F‐fluorodeoxyglucose with positron emission tomography/computed tomography for distinguishing appendiceal mucocele caused by mucinous adenocarcinoma from other pathologies

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

Cited by 18 publications

References 12 publications

Appendiceal mucocele: three cases with different clinical presentation and review of literature

Appendiceal mucocele: three cases with different clinical presentation and review of literature

Mucinous appendiceal neoplasms with or without pseudomyxoma peritonei: a review

Utility of computed tomography and 18F‐fluorodeoxyglucose with positron emission tomography/computed tomography for distinguishing appendiceal mucocele caused by mucinous adenocarcinoma from other pathologies

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Utility of computed tomography and ¹⁸F‐fluorodeoxyglucose with positron emission tomography/computed tomography for distinguishing appendiceal mucocele caused by mucinous adenocarcinoma from other pathologies