ArticlePleura and peritoneum2026
Proposed strategy after complete LAMN (low-grade appendiceal mucinous neoplasm) resection by different RENAPE units: need for a new consensus?
Article in Pleura and peritoneum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To evaluate current postoperative management strategies for incidentally discovered, completely resected low-grade appendiceal mucinous neoplasms (LAMNs) within the French RENAPE network and to assess the need for a new national consensus. Methods: A national survey was conducted among RENAPE expert centers using a structured questionnaire based on standardized postoperative risk scenarios. Survey items addressed surveillance strategies, indications for reoperation, and use of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Results: Ninety-one percent of centers responded. All reported systematic multidisciplinary discussion, centralized pathology and imaging review, standardized imaging, and tumor marker assessment. Marked heterogeneity was observed. For low-risk patients (R0 resection, no perforation, no extra-appendiceal mucin), 50 % recommended no follow-up and 50 % proposed long-term MRI surveillance. In intermediate-risk cases (limited perforation or adjacent mucin), 80 % favored MRI follow-up, while 20 % recommended diagnostic laparoscopy or prophylactic CRS-HIPEC. In high-risk scenarios with radiologic suspicion of implants, 60% proposed early CRS-HIPEC, whereas others preferred laparoscopic assessment or surveillance. Conclusions: This survey highlights wide variation in postoperative strategies for LAMNs within RENAPE, especially in intermediate-risk cases. While consensus exists on centralized review and imaging, significant evidence gaps persist regarding prophylactic HIPEC. These findings underscore the need for harmonized, evidence-based protocols and prospective data collection.
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