title: Propensity adjusted appraisal of the surgical strategy for appendiceal carcinoids.
abstract: BACKGROUND
  The treatment algorithm for appendiceal carcinoids is based on tumor size. We wanted to verify whether right hemicolectomy confers a survival advantage compared with appendectomy in patients with tumors larger than 2 cm.
  
  
  METHODS
  Data regarding patients with primary carcinoid tumors of the appendix were collected from the Surveillance, Epidemiology, and End Results program database. A propensity score with respect to surgical intervention was calculated with a binary logistic regression including gender, stage of disease, and age as covariates. The groups were matched with a 1:1 ratio, using the nearest neighbor algorithm. A Cox proportional hazards model adjusted for propensity score was implemented to assess the impact of surgical intervention on overall survival.
  
  
  RESULTS
  Only stage of disease differed between the groups (p = 0.011). After matching, based on the propensity score, our series was constituted of 109 patients undergoing appendectomy and 109 undergoing right hemicolectomy. The type of surgical intervention failed to reach statistical significance.
  
  
  CONCLUSIONS
  Right hemicolectomy did not seem to confer any survival advantage on patients with appendiceal carcinoids with a diameter >2 cm. For this reason, tumor size should not be considered an absolute indication for right hemicolectomy.
authors.affiliation: Postgraduate School of General Surgery, University of L'Aquila, L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ciarrocchi
authors.forename: R
authors.initials: R
authors.lastname: Pietroletti
authors.forename: F
authors.initials: F
authors.lastname: Carlei
authors.forename: S
authors.initials: S
authors.lastname: Necozione
authors.forename: G
authors.initials: G
authors.lastname: Amicucci
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001062:Appendectomy / Q000379:methods* / Q000706:statistics & numerical data; D001063:Appendiceal Neoplasms / Q000473:pathology* / Q000601:surgery*; D002276:Carcinoid Tumor / Q000473:pathology* / Q000601:surgery*; D003082:Colectomy / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome