Routine appendectomy in epithelial ovarian carcinoma: is it necessary?
OBJECTIVE
To detect risk factors for the appendiceal metastasis and to define the role of routine appendectomy in patients with epithelial ovarian carcinoma.


METHODS
A total of 285 patients with epithelial ovarian carcinoma who had undergone primary cytoreductive surgery including appendectomy were retrospectively evaluated. Appendiceal involvement was divided into 2 groups: gross and microscopic. Clinicopathologic variables were evaluated for possible significance in terms of appendiceal metastasis. A second analysis was performed using the same variables to detect a possible relation with microscopic metastasis. In a subgroup analysis, we also analyzed the role of routine appendectomy in patients with clinically early stage disease.


RESULTS
One-hundred six patients were found to have appendiceal metastasis (37%). Univariate and multivariate analysis revealed stage of disease as the unique factor determining the appendiceal metastasis (P < .001). Five patients with apparently stage I-II disease were upstaged due to isolated appendiceal metastasis (4.9%). In the second analysis excluding the patients with gross involvement, ascites was an independent predictor of microscopic involvement (P < .01).


CONCLUSIONS
Routine appendectomy is indicated in all epithelial ovarian carcinoma patients as part of the initial surgical staging procedure because of a considerable rate of upstaging in early stage disease and optimal cytoreduction in advanced stages.


METHODS
II-3.
Ayhan
Ali
A
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, and Department of Pathology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey.
Gultekin
Murat
M
Taskiran
Cagatay
C
Salman
Mehmet Coskun
MC
Celik
Nilufer Yigit
NY
Yuce
Kunter
K
Usubutun
Alp
A
Kucukali
Turkan
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000706:statistics & numerical data*; D001063:Appendiceal Neoplasms / Q000453:epidemiology / Q000556:secondary / Q000601:surgery*; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D020380:Needs Assessment; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology / Q000556:secondary / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology