Neuroendocrine neoplasms of the appendix are common GEP-NEN tumours. The aim of this retrospective study was review of patients records with this type of NEN, to determine natural history and outcomes base on localisation of primary tumour, resection margins, initial clinical stage and cell differentiation as single institution experience.
All patients with confirmed appendcieal NEN, with evaluation of resection margins, localisation of primary tumour and tumour type, based on WHO 2010 classification, were included of the study. Local ethics committee accepted this retrospective review.
A total of 97 pts were included in this study. A female to male ratio was 1,62. There were 79 pts with NETG1 (81%), 7 pts with NETG2 (7%), and 9 in goblet cell carcinoids (GCC) (9%) and 2 pts with MANEC (2%). The resection R0 was in 63 subjects in NETG1 (80%), 4 pts in NETG2 (57%) and 4 subjects with GCC (44%), no one of MANEC pts had R0. Resection R1 was noted in 13 subjects with NETG1 (16%), 2 pts with NETG2 (29%), and 3 pts with GCC (33%). All MANEC pts and 2 pts GCC had R2 resection. The 5 years OS in study group was 96%. There was no difference in 5 years OS between NETG1 and NETG2. There was no significant difference between 5 years OS in pts with R0 98% and R1 91%. In group of MANEC and GCC 5 years survival was 85%. The distribution of localisation of primary tumour within appendix presented in table below.
|Top||73 (75%)||65 (67%)||6 (6%)||0||2 (2%)|
|Middle||11 (11%)||3 (3%)||1 (1%)||1 (1%)||6 (6%)|
|Base||9 (9%)||7 (7%)||0||1 (1%)||1 (1%)|
|No data||3(3%||3 (3%)||0||0||0|
Appendcieal NEN had very favourable prognosis. Most of them are treated completely surgical. Even R1 resection had no significant impact on 5 years survival. Over 90% of cases are well or moderate differentiated. MANEC and GCC are very rare and represent less than 10% of all cases.
Clinical trial identification
Legal entity responsible for the study
Lukasz Jaskiewicz, Jaroslaw Cwikla, University of Warmia and Mazury in Olsztyn, Faculty of Medical Sciences, Department of Radiology
University of Warmia and Mazury in Olsztyn, Faculty of Medical Sciences, Department of Radiology
All authors have declared no conflicts of interest.