Journal of Endocrinological Investigation

, Volume 34, Issue 4, pp 255–259 | Cite as

Clinical value of right hemicolectomy for appendiceal carcinoids using pathologic criteria

  • K. I. Alexandraki
  • J. Griniatsos
  • K. I. Bramis
  • N. Ballian
  • N. Dimitriou
  • T. Giannakakis
  • C. Tsigris
  • E. Felekouras
  • G. A. Kaltsas
Original Articles

Abstract

Background: Appendiceal carcinoids (AC) are usually adequately treated by appendectomy. The European Neuroendocrine Tumours Society (ENETS) has recently reconsidered the previous pathologic criteria to identify patients at high risk of extra-appendiceal disease, who are thought to require right hemicolectomy (RHC). Aim: The aim of this retrospective, observational study was to evaluate previous and currently introduced criteria, in identifying patients with AC in whom RHC is justified. Subjects and methods: Twelve patients who underwent RHC for AC were retrospectively identified. Demographic and follow-up data were collected and appendectomy specimens were reviewed for the presence of indications leading to RHC defined as: tumor diameter ≥2 cm, tumor location at the base, mesoappendiceal extension, mitotic index Ki-67≥2%. RHC specimens were examined to identify evidence of extra-appendiceal disease, remaining and/or metastatic disease. Results: Four patients fulfilled two criteria and 8 one criterion for RHC. Two patients had tumors ≥2.0 cm, 5 located at the base, 8 invading the mesoappendix and periappendiceal fat; Ki-67 PI was 1% in all cases measured except one, in which it was 3%. Post-RHC, 3 patients (25%) had extra-appendiceal disease (no residual disease was identified in surgical margins); 1 had tumor at the colon specimen and 2 had lymph node metastasis. All 3 patients fulfilled only one pathologic criterion; 1 had tumor mesoappendiceal extension and 2 tumor location at the base of the appendix. Conclusions: Applying previous and currently introduced pathologic criteria, 25% of high-risk patients with AC had identifiable extra-appendiceal disease following RHC that might be not detected following the recently introduced ENETS criteria.

Key-words

Appendiceal carcinoid appendix carcinoid right hemicolectomy 

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Copyright information

© Italian Society of Endocrinology (SIE) 2011

Authors and Affiliations

  • K. I. Alexandraki
    • 1
  • J. Griniatsos
    • 2
  • K. I. Bramis
    • 2
  • N. Ballian
    • 2
  • N. Dimitriou
    • 2
  • T. Giannakakis
    • 3
  • C. Tsigris
    • 2
  • E. Felekouras
    • 2
  • G. A. Kaltsas
    • 1
  1. 1.Endocrine Unit, Department of PathophysiologyLaiko University Hospital, Athens Medical SchoolAthensGreece
  2. 2.1st Department of SurgeryLaiko University Hospital, Athens Medical SchoolGreece
  3. 3.1st Department of Internal MedicineAgii Anargiri Cancer HospitalAthensGreece

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