Carcinoid tumors of the appendix: a population-based study

Abstract

Background: Carcinoid tumors of the appendix are rare, and as such there are few data guiding their optimal treatment.

Methods: The analysis included all patients with malignant, typical carcinoid tumor of the appendix for whom complete data were available in the Surveillance, Epidemiology, and End Results database between 1988 and 2003. Clinicopathologic factors predicting lymph node (LN) involvement and survival were determined.

Results: LN metastases were present in 44 of 89 patients (49%), including 4 of 27 patients (15%) with tumors ≤ 1.0 cm, 16 of 34 patients (47%) with tumors > 1.0 cm but ≤ 2.0 cm, and 24 of 28 patients (86%) with tumors >2.0 cm. Increasing tumor size predicted LN involvement, whereas age, gender, and depth of tumor invasion did not. Excluding patients with distant metastasis (DM), the 10-year overall survival rates of patients with positive LNs and tumor sizes ≤1.0 cm, >1.0 cm but ≤2.0 cm, and >2.0 cm were 100%, 92%, and 91%, respectively.

Conclusions: Right hemicolectomy should be considered for patients with appendiceal carcinoid tumors >1.0 cm in size given their high incidence of LN metastases and limited data concerning the natural history of unresected LN metastases. Wiley-Liss, Inc.