Epidemiology, histopathology, clinical outcomes and survival of 50 cases of appendiceal mucinous neoplasms : Retrospective cross-sectional single academic tertiary care hospital experience

Background Appendicular neoplasms are rare, most commonly as carcinoids followed by appendicular mucinous neoplasms (AMN). To date, there remains controversy regarding the best treatment of AMN and factors affecting its prognosis. Method Retrospective chart review of patients operated for appendicular pathology (January 2011–December 2018, follow up to December 2020) at our institution. For all AMN patients, data included pre-operative clinical presentation, and operative/post-operative findings. Results 12454 patients underwent appendectomy, of whom 50 (0.4%) had AMN histopathologically (mean age = 47.2). Most patients had laparoscopic appendectomy as primary surgery. Low grade AMN was the most common subtype (n = 41, 82%), and pseudomyxoma peritonei (PMP) was found in 8 (16%) patients. Based on histopathology and margin involvement, the 50 patients were categorized into 3 prognostic categories of recurrence risk (no risk, 24 patients; low risk, 8; high recurrence risk, 18 patients). Disease-free survival (DFS) was lowest for high recurrence risk group (P
Highlights • Laparoscopic approach may be feasible for appendiceal mucinous neoplasms (AMN). • AMN can be categorized into 3 risk recurrence groups (No risk, low, and high). • AMN with acellular mucin at the margin may not require secondary surgery. • Higher tumor markers may indicate high risk of AMN recurrence.