Management of incidentally discovered appendiceal neuroendocrine tumors after an appendicectomy
作者机构：Department of General and Digestive SurgeryHospital Universitario de La PrincesaMadrid 28006Spain Department of SurgeryUniversidad Autónomade MadridMadrid 28029Spain Gastrointestinal and Endocrine Tumor UnitMedical Oncology DepartmentVall d´Hebron University HospitalVall d´Hebron Institute of OncologyBarcelona 08035Spain Department of Endocrinology and NutritionHospital Universitario de La PrincesaMadrid 28006Spain Department of PathologyHospital Universitario Puerta de HierroMadrid 28222Spain Department of PathologyUniversidad Autónoma de MadridMadrid 28029Spain Department of Nuclear MedicineVirgen de las Nieves University HospitalGranada 18014Spain Department of Endocrinology and NutritionHospital Universitario i Politècnic La FeValencia 46023Spain Division of Cancer SciencesSchool of Medical SciencesFaculty of BiologyMedicine and HealthUniversity of ManchesterManchester M139PLUnited Kingdom Department of Medical OncologyThe Christie NHS Foundation TrustManchester M204BXUnited Kingdom
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2022年第28卷第13期
页 面：1304-1314页
核心收录：
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Neuroendocrine tumors Carcinoid tumor Appendiceal neoplasms Colectomy Neoplasm grading Treatment outcome
摘 要：Appendiceal neuroendocrine tumors(aNETs)are an uncommon neoplasm that is relatively indolent in most cases.They are typically diagnosed in younger patients than other neuroendocrine tumors and are often an incidental finding after an appendectomy.Although there are numerous clinical practice guidelines on management of a NETs,there is continues to be a dearth of evidence on optimal treatment.Management of these tumors is stratified according to risk of locoregional and distant metastasis.However,there is a lack of consensus regarding tumors that measure 1-2 cm.In these cases,some histopathological features such as size,tumor grade,presence of lymphovascular invasion,or mesoappendix infiltration must also be considered.Computed tomography or magnetic resonance imaging scans are recommended for evaluating the presence of additional disease,except in the case of tumors smaller than 1 cm without additional risk factors.Somatostatin receptor scintigraphy or positron emission tomography with computed tomography should be considered in cases with suspected residual or distant disease.The main point of controversy is the indication for performing a completion right hemicolectomy after an initial appendectomy,based on the risk of lymph node metastases.The main factor considered is tumor size and 2 cm is the most common threshold for indicating a colectomy.Other factors such as mesoappendix infiltration,lymphovascular invasion,or tumor grade may also be considered.On the other hand,potential complications,and decreased quality of life after a hemicolectomy as well as the lack of evidence on benefits in terms of survival must be taken into consideration.In this review,we present data regarding the current indications,outcomes,and benefits of a colectomy.
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