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. 2021 May 2;21(1):228.
doi: 10.1186/s12893-021-01224-0.

Appendiceal adenocarcinoma found by surgery for acute appendicitis is associated with older age

John P Skendelas #  1   2   3   4 , Victor S Alemany #  1 , Vincent Au  1   3 , Devika Rao  1   2   3   4 , John McNelis  1   2   4 , Peter K Kim  5   6   7   8
Affiliations

Appendiceal adenocarcinoma found by surgery for acute appendicitis is associated with older age

John P Skendelas et al. BMC Surg. .

Abstract

Background: Appendectomy for acute appendicitis is the most common procedure performed emergently by general surgeons in the United States. The current management of acute appendicitis is increasingly controversial as non-operative management gains favor. Although rare, appendiceal neoplasms are often found as an incidental finding in the setting of appendectomy. Criteria and screening for appendiceal neoplasms are not standardized among surgical societies.

Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried for all patients who underwent appendectomy over a 9-year period (2010-2018). Over the same time period, patients who underwent appendectomy in two municipal hospitals in The Bronx, New York City, USA were reviewed.

Results: We found a 1.7% incidence of appendiceal neoplasms locally and a 0.53% incidence of appendiceal tumors in a national population sample. Both groups demonstrated an increased incidence of appendiceal carcinoma by age. This finding was most pronounced after the age of 40 in both local and national populations. In our study, the incidence of appendiceal tumors increased with each decade interval up to the age of 80 and peaked at 2.1% in patients between 70 and 79 years.

Conclusions: Appendiceal adenocarcinomas were identified in patients with acute appendicitis that seem to be associated with increasing age. The presence of an appendiceal malignancy should be considered in the management of older patients with acute appendicitis before a decision to embark on non-operative therapy.

Keywords: Acute appendicitis; Acute care surgery; Adenocarcinoma; Emergency general surgery; Mucinous neoplasm; Neuroendocrine tumor.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The incidence of adenocarcinoma, neuroendocrine, and low grade appendiceal mucinous neoplasm (LAMN) obtained from the National Surgical Quality Improvement Program (NSQIP) database from 2010 to 2018 categorized into 10 year age groups
Fig. 2
Fig. 2
The total number of local cases of appendicitis and those managed surgically reviewed from two Bronx municipal hospitals for the period 2010 through 2018. The number of cases found to be appendiceal cancers are further categorized into adenocarcinoma, neuroendocrine, and low grade appendiceal mucinous neoplasm (LAMN)
Fig. 3
Fig. 3
The incidence of adenocarcinoma, neuroendocrine, and low grade appendiceal mucinous neoplasm (LAMN) from two Bronx municipal hospitals for the period 2010 through 2018 categorized into 10-year age groups
See this image and copyright information in PMC

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