ArticleJournal of the American College of Surgeons2019
Practice Patterns and Guideline Non-Adherence in Surgical Management of Appendiceal Carcinoid Tumors.
Article in Journal of the American College of Surgeons, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 20 citations in OpenAlex.
- Appendiceal Neuroendocrine Tumors: Prognostic Role of Mesoappendiceal Invasion and Implications for Recommending Right Hemicolectomy versus Simple Appendectomy.Annals of surgical oncology · 2025Article
- Evaluating the necessity of right hemicolectomy in high-risk appendiceal neuroendocrine tumors: a retrospective analysis.BMC surgery · 2025Article
- Role of colectomy in the management of appendiceal tumors: a retrospective cohort study.BMC gastroenterology · 2023Article
- Mixed adenoneuroendocrine carcinoma originating from the appendix and colorectum: a comparative analysis of a large population-based database.Techniques in coloproctology · 2023Article
- Role of Advanced Gastrointestinal Endoscopy in the Comprehensive Management of Neuroendocrine Neoplasms.Cancers · 2023Review
- An Update on Appendiceal Neuroendocrine Tumors.Current treatment options in oncology · 2023Review
- Management of incidentally discovered appendiceal neuroendocrine tumors after an appendicectomy.World journal of gastroenterology · 2022Review
- Synchronous primary neuroendocrine and mucinous epithelial tumors present in the same appendix. Case report of 2 patients.International journal of surgery case reports · 2020Article
Corrections and comments
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- Erratum issuedCorrection.2020
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundSurgical management of appendiceal carcinoid tumors is heavily debated, despite National Comprehensive Cancer Network guidelines recommending aggressive resection of tumors >2 cm. We investigated national practice patterns and the predictors and impact of guideline non-adherence. STUDY
designThe National Cancer Database was queried for cases of appendiceal carcinoids diagnosed from 2004 to 2015 treated with either appendectomy or hemicolectomy. Multivariable logistic regression, adjusted for demographic and clinical factors, identified associations with the procedure type among patients stratified by tumor size ≤2 cm and >2 cm. Cox Proportional Hazards then identified associations with overall survival among stratified patient groups.
resultsOf 3,198 cases of appendiceal carcinoids, 1,893 appendectomies and 1,305 hemicolectomies were identified. Contrary to National Comprehensive Cancer Network guidelines, 32.4% of tumors ≤2 cm were treated with hemicolectomy and 31.3% of tumors >2 cm were treated with definitive appendectomy. Hemicolectomy for small tumors was associated with age 65 years and older (odds ratio [OR] 2.4; 95% CI 1.7 to 3.3; reference group age 18 to 39 years), history of malignancy (OR 2.0; 95% CI 1.6 to 2.6), tumor size 1.1 to 2 cm (OR 2.8; 95% CI 2.3 to 3.4; reference group size ≤1 cm), and lymphovascular invasion (OR 2.2; 95% CI 1.6 to 3.2); appendectomy for large tumors was associated with age 65 years and older only (OR 2.2; 95% CI 1.1 to 4.2). Procedure type was not associated with survival for small or large tumors (hazard ratio 1.0; 95% CI 0.7 to 1.4 and hazard ratio 1.1; 95% CI 0.6 to 2.0, respectively).
conclusionsDespite well-known size-based treatment guidelines for appendiceal carcinoids, one-third of patients in the US undergo hemicolectomy for small tumors and appendectomy for large tumors. Guideline non-adherence, however, is not associated with overall survival. Reasons for these practice patterns should be explored, and guidelines revisited.
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