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International Journal of Colorectal Disease

Published in:

01-01-2019 | Original Article

Appendiceal neoplasm risk associated with complicated acute appendicitis—a population based study

Authors: Elina Lietzén, Juha M. Grönroos, Jukka-Pekka Mecklin, Ari Leppäniemi, Pia Nordström, Tero Rautio, Tuomo Rantanen, Juhani Sand, Hannu Paajanen, Anne Kaljonen, Paulina Salminen

Published in: International Journal of Colorectal Disease | Issue 1/2019

Abstract

Purpose

Appendiceal tumors are rare, but high neoplasm rates have been reported at interval appendectomy after periappendicular abscess. Non-operative management of uncomplicated acute appendicitis has shown promising results. The data on appendiceal tumor incidence and presentation among acute appendicitis patients is limited, especially in patient cohorts differentiating between uncomplicated and complicated acute appendicitis. Objective was to assess appendiceal tumor incidence and tumor association to appendicitis in patients with uncomplicated and complicated acute appendicitis.

Methods

This nationwide population-based registry study was conducted from 2007 to 2013. The Finnish Cancer Registry and the National Institute for Health Registry were used to combine data on all appendiceal tumors and acute appendicitis diagnosis with medical reports evaluated at eight study hospitals.

Results

Altogether, 840 appendiceal tumors were identified, and out of these, 504 patient reports were reviewed, including 472 patients in this study. Tumor was diagnosed at appendectomy for suspected acute appendicitis in 276 patients (58%). In the whole study, histologically acute appendicitis and tumor were both present in 53% (n = 250), and out of these, 41% (n = 102) were complicated and 59% (n = 148) uncomplicated acute appendicitis. The associated tumor risk was significantly higher in complicated acute appendicitis compared with uncomplicated cases (3.24% vs. 0.87%, p < 0.001). Overall tumor prevalence among acute appendicitis patients was 1.24%.

Conclusions

Appendiceal tumor prevalence in acute appendicitis was low. Tumor risk was significantly higher in complicated acute appendicitis compared with uncomplicated acute appendicitis. The risk of missed appendiceal tumors related to antibiotic therapy of uncomplicated acute appendicitis is very low.

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Title: Appendiceal neoplasm risk associated with complicated acute appendicitis—a population based study
Authors: Elina Lietzén
Juha M. Grönroos
Jukka-Pekka Mecklin
Ari Leppäniemi
Pia Nordström
Tero Rautio
Tuomo Rantanen
Juhani Sand
Hannu Paajanen
Anne Kaljonen
Paulina Salminen
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 1/2019
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-018-3156-x

At a glance: The STEP trials

Springer Medicine

Appendiceal neoplasm risk associated with complicated acute appendicitis—a population based study

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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