SURGICAL MANAGEMENT OF APPENDIX TUMORS : A SINGLE-CENTER REVIEW OF 15 YEARS

Objective: Primary neoplasms of the appendix are rare and most clinicians are unfamiliar with them. The selected approach may differ, ranging from appendectomy to cytoreductive sur-gery. We aimed to present our clinical experience with the surgi-cal management of appendix tumors. Materials and Methods: 4,450 patients with a history of appen-dectomy from January 2006 to February 2021 were analyzed retrospectively. Patients diagnosed with "serrated lesion/pol-yp, low/high-grade appendiceal mucinous neoplasm (LAMN/ HAMN), mucinous/non-mucinous/goblet cell adenocarcinoma, neuroendocrine tumor (NET)" were included in the study. His-tological evaluations, surgical procedures, follow-up data, and survival outcomes were evaluated. Results: Among 132 [F:87 (65.9%)] patients diagnosed with ap-pendix tumors, 27 (20.5%) were in the benign group (Group A), 61 (46.2%) were in the borderline group (Group B), and 44 (33.3%) were in the malignant group (Group C). Appendectomy and right hemicolectomy were performed as the initial operations in 105 (79.5%) and 27 (20.5%) patients, respectively. Seventeen patients (12.9%) with a previous history of appendectomy received right hemicolectomy (n=9; due to surgical margin positivity) and Cy-toreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) (n=8; due to recurrence) as redo surgery during the follow-up period. Appendectomy was sufficient for 88 (66.6%) patients. Adenocarcinoma was revealed as a statistical-ly significant factor for recurrence-free survival (RFS) (HR=7.28, p=0.049). Malignancy (HR=3.76, p=0.036) and age (>= 60) (HR=3.86, p=0.006) were significant factors of overall survival (OS). Conclusion: Appendectomy is efficient in the treatment of appendix tumors for selected cases considering low morbidity of the procedure and favorable survival outcomes. For advanced-stage tumors, extended resections combined with chemotherapy should be the preferred approach.