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This research aims to evaluate the optimal surgical management for 1-2 cm appendiceal neuroendocrine tumors comparing appendectomy and right hemicolectomy.

May 2, 20260 citations

De-Escalating Surgery for 1-2 cm Appendiceal Neuroendocrine Tumors: A North American Multi-Center Analysis.

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RMR. MillerCreighton University PTPo Hong TanWinnMed ASAndrew SaleebMayo Clinic Hospital

Key Points

This research aims to evaluate the optimal surgical management for 1-2 cm appendiceal neuroendocrine tumors comparing appendectomy and right hemicolectomy.
Included 65 patients with 1-2 cm appendiceal neuroendocrine tumors from three Mayo Clinic sites (1972-2024).
Primary outcomes were recurrence and all-cause mortality analyzed after resection.
Lymph node metastasis assessed in patients with lymphadenectomy.
No survival differences were found between appendectomy (APY) and right hemicolectomy (RHC) patients.
No recurrences were observed during a median follow-up of 6.25 years (IQR 2.44-12.63).
Lymph node positivity did not affect survival outcomes.

Abstract

BACKGROUND AND OBJECTIVES: NCCN guidelines recommend right hemicolectomy (RHC) for appendiceal neuroendocrine tumors (aNETs) > 2 cm and observation for 1.5 cm, stage T3/T4, and lymphovascular invasion were not associated with nodal metastasis. No survival differences were observed between APY and RHC. LN positivity did not impact survival. No recurrences occurred during a median follow-up of 6.25 years (IQR 2.44-12.63). CONCLUSIONS: Among patients with 1-2 cm aNETs, RHC conferred no survival benefit over APY. Absence of recurrence and the limited prognostic value of nodal disease suggest APY alone may suffice for this population.

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De-Escalating Surgery for 1-2 cm Appendiceal Neuroendocrine Tumors: A North American Multi-Center Analysis.

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