Original Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Surg. Jan 27, 2011; 3(1): 7-12
Published online Jan 27, 2011. doi: 10.4240/wjgs.v3.i1.7
Clinicopathological features and the outcome of surgical management for adenocarcinoma of the appendix
Salman Yousuf Guraya, Hamdi Hameed Almaramhy
Salman Yousuf Guraya, Hamdi Hameed Almaramhy, Department of Surgery, College of Medicine, Taibah University, PO Box 30054, Al Madina Al Munawara 41477, Saudi Arabia
Author contributions: Guraya SY and Almaramhy HH wrote this paper.
Correspondence to: Dr. Salman Yousuf Guraya, FRCS, Associate Professor of Surgery, Consultant Minimally Invasive Surgeon, Department of Surgery, College of Medicine, Taibah University, PO Box 30054, Al Madina Al Munawara 41477, Saudi Arabia. syousuf@taibahu.edu.sa
Telephone: +966-4-553375969 Fax: +966-4-8461407
Received: June 22, 2010
Revised: January 2, 2011
Accepted: January 9, 2011
Published online: January 27, 2011
Abstract

AIM: To present a comprehensive analysis of incidence, clinicopathological features, appropriateness of surgical procedures, and survival for adenocarcinoma of the appendix.

METHODS: A retrospective case analysis was conducted for the 10-year period 1998-2008. All patients diagnosed with adenocarcinoma of the appendix were analyzed for their demographics details, clinical features, tumor incidence and characteristics, tumor stage, surgical procedures performed, and their survival.

RESULTS: Nine thousand three hundred and twenty-three patients underwent appendectomies during the study period, and of these, 10 (0.1%: 8 men and 2 women with a mean age of 53.1 years, age range 21-83 years) were found to have primary adenocarcinoma of the appendix. Appendicular neoplasia was not suspected pre-operatively in any of the patients. Six (60%) patients underwent secondary right hemicolectomy. Four (40%) cases had appendectomy alone, and two of them died, whereas all those who underwent right hemicolectomy are alive and disease free. Five (50%) were reported to have grade 1 disease, three (30%) grade 2, and two (20%) grade 3 with mean survival of 34, 48, and 22 mo, respectively. Six (60%) patients presented with advanced disease (Duke’s C and D). At the end of follow up (mean period: 37.9 mo), eight patients are alive and disease free at the end of follow up. Overall mean survival was 36.3 mo (confidence interval; 16%-56%) with 41.3 and 16 mo for men and women, respectively. Mean survival for those with and without lymph node involvement was 33.6 and 40.2 mo, respectively. Right hemicolectomy gave better results than appendectomy alone, although the difference was not statistically significant due to the small number of cases.

CONCLUSION: Adenocarcinoma of the appendix is extremely rare neoplasm with varied presentations, and is usually advanced when diagnosed. Right hemicolectomy is the treatment of choice for such tumors.

Keywords: Adenocarcinoma of the appendix; Appendectomy; Appendicitis; Right hemicolectomy