Incidence and risk factors of appendiceal neoplasms in patients with acute appendicitis undergoing routine appendectomy
Shaima Ramadan, Louise Pedersen, Pamela BuchwaldAbstract
Introduction
Acute appendectomy is one of the most common procedures in general surgery, with approximately 12 500 appendectomies performed annually in Sweden. Appendiceal neoplasia is reported in 0.9–1.4% of resected specimens. This study aimed to determine the incidence of appendiceal neoplasms in patients with acute appendicitis undergoing appendectomy, and to identify potential risk factors.
Methods
This study included all patients ≥18 years with acute appendicitis that underwent acute appendectomy during 2022–2024 at Skåne University Hospital. Patient data was retrieved retrospectively from medical charts. Data included patient demographics, medical history, clinical findings and histopathological results. Statistical analysis was performed using Stata.
Results
This retrospective cohort study identified a total of 1769 patients. Preliminary results include data from 1165 patients. Sixteen (1.4%) patients had a histopathologically confirmed appendiceal neoplasm; 6 neuroendocrine tumours, 4 goblet cell adenoocarcinomas, 3 low-grade appendiceal mucinous neoplasms and 3 adenocarcinomas. Univariable regression analysis identified age >60 years (P = 0.001), type 2 diabetes mellitus (P = 0.006) and hypertension (P = 0.002) as factors associated with appendiceal neoplasm. There was also a trend toward increased rates of previous abdominal surgery (P = 0.067) and conversion to open appendectomy (P = 0.053) in this group.
Discussion
Preliminary results confirm that appendiceal neoplasms are rare following acute routine appendectomy. Histopathological examination may be of highest importance in patients >60 years or with high comorbidity. Conclusions are limited by the small and heterogeneous cohort of appendiceal neoplasms.