The management of incidental appendiceal mucinous neoplasm encountered during appendectomy: a single center experience

Abstract Purpose The management of incidental appendiceal mucinous neoplasm (IAMN) was confusing with difficult decision-making. This study was to investigate the association of variables from the initial operation to cytoreductive surgery with overall survival. Methods One hundred and thirty patients of IAMN treated at Aerospace Center Hospital were retrospectively analyzed from January 2014 to December 2020. A total of 82 IAMN patients who underwent reoperation with cytoreductive surgery (CRS ) and had available data on the date of their initial operation was included. Results Of these 82 IAMN patients, the mean time from the initial operation to CRS was 19 months (1-146 months). The 5-year OS rate was 69.8%, and the median OS was 39 months (1–73 months). The patients who underwent CRS within six months had a higher radical rate (63.3% vs. 36.7%) with lower tumor burden and better survival. No significant difference was found in patients with right hemicolectomy or prior systemic chemotherapy. Multivariate analysis identified the completeness of cytoreduction score and the pathologic subtype of peritoneal pseudomyxoma (PMP) as independent prognostic factors. Conclusion Extended surgery and systematic chemotherapy are not suitable for IAMN patients. It is more important to identify the pathology and accept standard therapy in academic medical centers within 6 months.