Surgical procedures for neuroendocrine neoplasms of the appendix - a consensus guideline

Abstract

INTRODUCTION : According to the consensus and the recommendations of the European Neuroendo­crine Tumor Society (ENETS), the annual incidence rate of neuroendocrine appendicular tumours is 0.15- 0.6/100000. They are little more common in women aged between 40 and 50 years. These neoplasms amount to 30-80% of all appendicular tumours. Their evolution is, usually, asymptomatic and they are diagnosed accidentally during conventional or laparoscopic appendectomy. In the past, the surgical approach used to depend on tumour localization. At presence, this localization is not a decisive factor in the choice of a sur­gical approach. Our purpose was to demonstrate the consensus guideline and the recommendations of EN­ETS 2017 for surgical procedures in neuroendocrine appendicular neoplasms and to analyze the difference in the survival rate following various surgical interventions. MATERIAL AND METHODS : Literature overview included studies dealing with the surgical treatment of the neuroendocrine appendicular neoplasms including the most recent consensus guideline of ENETS 2017 on the topic. RESULTS : Our analysis revealed that according to ENETS 2017, tumour size, localization and tumour cell invasion into the mesoappendix determined the type and volume of surgical intervention. For tumours less than 1 cm (T1 according to ENETS pathological classification), a simple appendectomy was recommended. In T1 tumours, this surgical procedure resulted in 100% survival rate. CONCLUSION : ENETS 2017 recommends to observe the last established consensus guideline despite the fact that the studies up-to-now do not show any significant difference in the survival rate after appendectomy because of a neuroendocrine tumour of the appendix and right hemicolectomy. Scr Sci Med 2017;49(3):11-14