Incidence of synchronous appendiceal neoplasm in patients with colorectal cancer and its clinical significance

Varut Lohsiriwat,Darin Lohsiriwat,Akkrarash Vongjirad

doi:10.1186/1477-7819-7-51

Varut Lohsiriwat, Darin Lohsiriwat + Show 1 more

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https://doi.org/10.1186/1477-7819-7-51

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Abstract

BackgroundThe aims of this study were to evaluate the incidence of synchronous appendiceal neoplasm in patients with colorectal cancer, and to determine its clinical significance.MethodsPathological reports and medical records were reviewed of patients with colorectal adenocarcinoma who underwent oncological resection of the tumor together with appendectomy at the Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand between September 2000 and April 2008.ResultsThis study included 293 patients with an average age of 62 years (range 19–95) and 51 percent were male. Of the patients studied, 228 (78 percent) had right hemicolectomy, whereas the others (22 percent) had surgery for left-sided colon cancer or rectal cancer. One patient (0.3 percent) had epithelial appendiceal neoplasm (mucinous cystadenoma) and 3 patients (1.0 percent) had metastatic colorectal cancer in the mesoappendix. However, the presence of synchronous appendiceal tumors and/or metastasis did not alter postoperative management, as these patients had received adjuvant therapy and were scheduled for surveillance program because of nodal involvement.ConclusionThe incidence of synchronous primary appendiceal neoplasm and secondary (metastatic) appendiceal neoplasm in colorectal cancer patients was 0.3 and 1.0 percent, respectively. However, these findings did not change the postoperative clinical management.

Highlights

The aims of this study were to evaluate the incidence of synchronous appendiceal neoplasm in patients with colorectal cancer, and to determine its clinical significance
The aims of this study were to evaluate the incidence of synchronous appendiceal neoplasm in patients with resectable colorectal cancer (CRC) in a university hospital, and to determine the clinical significance of these findings
Pathological reports and medical records were retrospectively reviewed of patients with colorectal adenocarcinoma who underwent oncological resection of the tumor together with appendectomy at the Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand between September 2000 and April 2008

Summary

Introduction

The aims of this study were to evaluate the incidence of synchronous appendiceal neoplasm in patients with colorectal cancer, and to determine its clinical significance. Synchronous colorectal cancer (CRC) has been reported in 0.6–1.4 percent of patients and metachronous CRC in 1–8 percent of patients [1]. It has been reported that almost a quarter of patients with appendiceal cancer are found to have synchronous or metachronous neoplasms elsewhere in the large intestine [2,3]. There have been increasing advances in both endoscopy and radiology, the appendiceal mucosa remains inaccessible and the accuracy of preoperative diagnosis of appendiceal neoplasm is still poor. A correct diagnosis is made in less than half of the cases [4]. Several case reports of synchronous (page number not for citation purposes)

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