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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. MillerPTPo Hong TanASAndrew Saleeb

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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Cite This Study

Miller et al. (2026) studied this question.

synapsesocial.com/papers/69f594fc71405d493afffe3bhttps://doi.org/10.1002/jso.70274
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