Ulus Travma Acil Cerrahi Derg. 2019; 25(2): 118-122 | DOI: 10.14744/tjtes.2019.38283

Neuroendocrine tumor of the appendix: Twelve years of results from a single institution

Seracettin Eðin¹, Gülçin Kamalý², Sedat Kamalý¹, Berk Gökçek¹, Metin Yeþiltaþ¹, Semih Hot¹, Dursun Özgür Karakaþ^1
1Department of General Surgery, University of Health Sciences, Okmeydaný Training and Research Hospital, Ýstanbul-Turkey
²Department of Pathology, University of Health Sciences, Okmeydaný Training and Research Hospital, Ýstanbul-Turkey

BACKGROUND: The aim of this study was to investigate the incidence of appendiceal neuroendocrine tumors (NET) in an acute appendicitis cohort, as well as to investigate the behavioral form of the tumor. Our secondary aim was to investigate survival in patients with appendiceal NET.
METHODS: Between February 2006 and June 2018, 6518 appendectomies were performed for acute appendicitis in the department of surgery, University of Health Sciences, Okmeydaný Education and Research Hospital, Ýstanbul, Turkey. The medical records of these consecutive 6518 appendectomy patients were evaluated retrospectively. After the histopathological analysis, a total of 22 patients were identified as cases of appendiceal NET. These patients were included in the study. A retrospective analysis of data including gender, age, intraoperative surgical findings, duration of postoperative follow-up and survival, tumor localization, the diameter of the tumor, tumor grade, invasion, surgical margin, and stage of the tumor was performed.
RESULTS: The incidence of appendiceal NET was 0.33%. Eleven patients were diagnosed as primary pathological stage pT1aN0M0 according to the European Neuroendocrine Tumor Society guidelines. One patient was diagnosed as primary pathological stage pT1bN0M0, and 10 patients were diagnosed as primary pathological stage pT2N0M0. The median tumor diameter was 7.6 mm. There was no patient with a tumor diameter greater than 20 mm.
CONCLUSION: The incidence of appendiceal NET in our study is consistent with that stated in the literature. The results of our research suggest that further surgical procedures for NETs that occur coincidentally in patients of the AA cohort are often unnecessary. In addition, the study revealed that disease-free survival (100%) was good over a mean follow-up of 59.2 months.

Keywords: Appendicitis, appendix; neuroendocrine tumor; World Health Organization.

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Apendiksin nöroendokrin tümörü: Bir kurumun 12 yýllýk sonuçlarý

Seracettin Eðin¹, Gülçin Kamalý², Sedat Kamalý¹, Berk Gökçek¹, Metin Yeþiltaþ¹, Semih Hot¹, Dursun Özgür Karakaþ^1
1Saðlýk Bilimleri Üniversitesi, Okmeydaný Eðitim Ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Ýstanbul
²Saðlýk Bilimleri Üniversitesi, Okmeydaný Eðitim Ve Araþtýrma Hastanesi, Patoloji Laboratuvarý, Ýstanbul

AMAÇ: Akut apandisit tanýsýyla apendektomi yapýlan hasta topluluðunda apendiks nöroendokrin tümörlerinin (NET) görülme sýklýðýný ve tümörün davranýþ þeklini araþtýrmayý amaçladýk. Ýkincil amacýmýz apandisiyel NET’li hastalarda saðkalýmý araþtýrmaktýr.
GEREÇ VE YÖNTEM: Þubat 2006–Haziran 2018 tarihleri arasýnda Saðlýk Bilimleri Üniversitesi Ýstanbul Okmeydaný Eðitim ve Araþtýrma Hastanesi Genel Cerrahi Kliniði’nde akut apendisit tanýsýyla 6518 apendektomi uygulandý. Bu ardýþýk 6518 apendektomi hastasýnýn týbbi kayýtlarý geriye dönük olarak deðerlendirildi. Histopatolojik analizlerden sonra toplam 22 hasta apendiks NET olarak tanýmlandý. Bu hastalar çalýþmaya dahil edildi. Cinsiyet, yaþ, ameliyat sýrasýnda cerrahi bulgular, ameliyat sonrasý takip süresi ve saðkalým süresi, tümör lokalizasyonu, tümör çaplarý, tümör derecesi, invazyon, cerrahi sýnýr ve tümör evresi gibi geriye dönük bir veri tabaný elde edildi.
BULGULAR: Apendiks NET’lerinin görülme sýklýðý %0.33 idi. On bir hastaya Avrupa Nöroendokrin Tümör Derneði Kýlavuzu’na göre primer patolojik evre pT1aN0M0 tanýsý konuldu. Ayrýca bir hastaya primer patolojik evre pT1bN0M0 ve on hastaya primer patolojik evre pT2N0M0 tanýsý konuldu. Ortalama tümör çapý 7.6 mm idi. Tümör çapý 20 mm’den daha büyük olan herhangi bir hasta yoktu.
TARTIÞMA: Çalýþmadaki apendiks NET görülme sýklýðý literatür ile uyumludur. Çalýþmanýn sonuçlarý akut apandisit hastalarýnda rastlantýsal olarak ortaya çýkan NET’ler için daha ileri cerrahi iþlemlerin gereksiz olduðunu göstermektedir. Buna ek olarak, çalýþma hastalýksýz saðkalýmýn (%100), ortalama 59.2 aylýk takipte iyi olduðunu göstermektedir.

Anahtar Kelimeler: Apendiks, apendisit; Dünya Saðlýk Örgütü; nöroendokrin tümör.

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