Elina Lietzén1,2, Juha M Grönroos3,4, Jukka-Pekka Mecklin5,6, Ari Leppäniemi7,8, Pia Nordström9,10, Tero Rautio11,12, Tuomo Rantanen13,14,15, Juhani Sand16, Hannu Paajanen17, Anne Kaljonen18, Paulina Salminen3,4. 1. Division of Digestive Surgery and Urology, Department of Digestive Surgery, Turku University Hospital, Kiinanmyllynkatu 4-8, 20520, Turku, Finland. elina.lietzen@tyks.fi. 2. University of Turku, Turku, Finland. elina.lietzen@tyks.fi. 3. Division of Digestive Surgery and Urology, Department of Digestive Surgery, Turku University Hospital, Kiinanmyllynkatu 4-8, 20520, Turku, Finland. 4. University of Turku, Turku, Finland. 5. Department of Surgery, Jyväskylä Central Hospital and Sport and Health Sciences, Jyväskylä, Finland. 6. University of Jyväskylä, Jyväskylä, Finland. 7. Department of Gastrointestinal Surgery, Helsinki University Central Hospital, Helsinki, Finland. 8. University of Helsinki, Helsinki, Finland. 9. Division of Surgery, Gastroenterology and Oncology, Tampere University Hospital, Tampere, Finland. 10. University of Tampere, Tampere, Finland. 11. Department of Surgery, Division of Gastroenterology, Oulu University Hospital, Oulu, Finland. 12. University of Oulu, Oulu, Finland. 13. Department of Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland. 14. Department of Surgery, Kuopio University Hospital, Kuopio, Finland. 15. University of Kuopio, Kuopio, Finland. 16. Health and Medical Services, Päijät-Häme Joint Authority for Health and Wellbeing, Lahti, Finland. 17. Department of Surgery, Mikkeli Central Hospital, Mikkeli, Finland. 18. The Department of Biostatistics, University of Turku, Turku, Finland.
Abstract
PURPOSE: Appendiceal tumors are rare, but high neoplasm rates have been reported at interval appendectomy after periappendicular abscess. Non-operative management of uncomplicated acute appendicitis has shown promising results. The data on appendiceal tumor incidence and presentation among acute appendicitis patients is limited, especially in patient cohorts differentiating between uncomplicated and complicated acute appendicitis. Objective was to assess appendiceal tumor incidence and tumor association to appendicitis in patients with uncomplicated and complicated acute appendicitis. METHODS: This nationwide population-based registry study was conducted from 2007 to 2013. The Finnish Cancer Registry and the National Institute for Health Registry were used to combine data on all appendiceal tumors and acute appendicitis diagnosis with medical reports evaluated at eight study hospitals. RESULTS: Altogether, 840 appendiceal tumors were identified, and out of these, 504 patient reports were reviewed, including 472 patients in this study. Tumor was diagnosed at appendectomy for suspected acute appendicitis in 276 patients (58%). In the whole study, histologically acute appendicitis and tumor were both present in 53% (n = 250), and out of these, 41% (n = 102) were complicated and 59% (n = 148) uncomplicated acute appendicitis. The associated tumor risk was significantly higher in complicated acute appendicitis compared with uncomplicated cases (3.24% vs. 0.87%, p < 0.001). Overall tumor prevalence among acute appendicitis patients was 1.24%. CONCLUSIONS: Appendiceal tumor prevalence in acute appendicitis was low. Tumor risk was significantly higher in complicated acute appendicitis compared with uncomplicated acute appendicitis. The risk of missed appendiceal tumors related to antibiotic therapy of uncomplicated acute appendicitis is very low.
PURPOSE:Appendiceal tumors are rare, but high neoplasm rates have been reported at interval appendectomy after periappendicular abscess. Non-operative management of uncomplicated acute appendicitis has shown promising results. The data on appendiceal tumor incidence and presentation among acute appendicitispatients is limited, especially in patient cohorts differentiating between uncomplicated and complicated acute appendicitis. Objective was to assess appendiceal tumor incidence and tumor association to appendicitis in patients with uncomplicated and complicated acute appendicitis. METHODS: This nationwide population-based registry study was conducted from 2007 to 2013. The Finnish Cancer Registry and the National Institute for Health Registry were used to combine data on all appendiceal tumors and acute appendicitis diagnosis with medical reports evaluated at eight study hospitals. RESULTS: Altogether, 840 appendiceal tumors were identified, and out of these, 504 patient reports were reviewed, including 472 patients in this study. Tumor was diagnosed at appendectomy for suspected acute appendicitis in 276 patients (58%). In the whole study, histologically acute appendicitis and tumor were both present in 53% (n = 250), and out of these, 41% (n = 102) were complicated and 59% (n = 148) uncomplicated acute appendicitis. The associated tumor risk was significantly higher in complicated acute appendicitis compared with uncomplicated cases (3.24% vs. 0.87%, p < 0.001). Overall tumor prevalence among acute appendicitispatients was 1.24%. CONCLUSIONS:Appendiceal tumor prevalence in acute appendicitis was low. Tumor risk was significantly higher in complicated acute appendicitis compared with uncomplicated acute appendicitis. The risk of missed appendiceal tumors related to antibiotic therapy of uncomplicated acute appendicitis is very low.
Authors: Maximilian Brunner; Philipp Lapins; Melanie Langheinrich; Justus Baecker; Christian Krautz; Stephan Kersting; Georg F Weber; Robert Grützmann; Matthias Maak Journal: Int J Colorectal Dis Date: 2019-12-06 Impact factor: 2.571
Authors: M D M Bolmers; J de Jonge; C C van Rossem; A A W van Geloven; W A Bemelman Journal: Int J Colorectal Dis Date: 2020-07-08 Impact factor: 2.571
Authors: Jenny Alajääski; Elina Lietzén; Juha M Grönroos; Jukka-Pekka Mecklin; Ari Leppäniemi; Pia Nordström; Tero Rautio; Tuomo Rantanen; Juhani Sand; Hannu Paajanen; Helena Ollila; Paulina Salminen Journal: Int J Colorectal Dis Date: 2022-04-26 Impact factor: 2.796