Prevalence of Appendiceal Pathology in Ovarian Cancer When Appendectomy is performed during Surgical Treatment
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Abstract
Objectives: Pathological appendectomy findings during the surgical staging procedure for ovarian cancer can determine the extent of the cancer, and specific treatment depends on whether a primary appendiceal malignancy or an ovarian metastasis is involved. This study aimed to evaluate appendiceal histology from comprehensive surgery for epithelium ovarian cancer.
Materials and Methods: We retrospectively evaluated patients who underwent cytoreductive surgery for primary and secondary epithelium ovarian cancer and who had undergone an appendectomy between 2003 and 2016. The clinicopathologic findings concerning ovarian cancer and the appendix, and risk factors for appendiceal abnormalities were presented.
Results: Of 340 patients with ovarian cancers, 322 (94.7%) were diagnosed with primary epithelium ovarian cancer and 60.6% were at an early stage. Mucinous carcinoma was the most common in histology (40%). Appendiceal malignancies were identified in 53 (15.6%) patients, of whom 42 (12.4%) had secondary metastasis from ovarian cancer, and two patients had stomach or breast metastases. Primary appendiceal neoplasms were identified in nine patients, with three patients presenting with synchronous ovarian cancers. A grossly abnormal appendix (odds ratio [OR] 27.6, 95% confidence interval [CI] 7.1–107.3, p < 0.001), advanced stage ovarian cancer (OR 114.6, 95%CI 14.6-99.4, p < 0.001), and secondary ovarian cancer (OR 86.7, 95%CI 8.5-887.7, p < 0.001) were associated with appendiceal neoplasm in multiple logistic regression analysis.
Conclusion: Appendiceal neoplasm accompanied a significant number of ovarian cancers. Appendectomy is recommended as part of surgical staging in abnormal looking appendices, advanced ovarian cancer, and secondary ovarian cancer.
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