title: Is there truly an oncologic indication for interval appendectomy?
abstract: BACKGROUND
  The rate of recurrent appendicitis is low following nonoperative management of complicated appendicitis. However, recent data suggest an increased rate of neoplasms in these cases.
  
  
  METHODS
  The study was a retrospective review of patients with acute appendicitis at 2 university-affiliated community hospitals over a 12-year period. The primary outcome measure was the incidence of appendiceal neoplasm following interval appendectomy.
  
  
  RESULTS
  Six thousand thirty-eight patients presented with acute appendicitis. Appendectomy was performed in 5,851 (97%) patients at the index admission. Of the 188 patients treated with initial nonoperative management, 89 (47%) underwent interval appendectomy. Appendiceal neoplasms were identified in 11 of the 89 (12%) patients. These included mucinous neoplasms (n = 6), carcinoid tumors (n = 4), and adenocarcinoma (n = 1). The rate of neoplasm in patients over age 40 was 16%.
  
  
  CONCLUSIONS
  There is a significant rate of neoplasms identified in patient over age 40 undergoing interval appendectomy. This should be considered following nonoperative management of complicated appendicitis.
authors.affiliation: Grand Rapids Medical Education Partners, General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA. Electronic address: paul.wright@grmep.com.
authors.forename: Gerald Paul
authors.initials: GP
authors.lastname: Wright
authors.affiliation: Grand Rapids Medical Education Partners, General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Mater
authors.affiliation: Grand Rapids Medical Education Partners, General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Carroll
authors.affiliation: Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Choy
authors.affiliation: Grand Rapids Medical Education Partners, General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA; Spectrum Health Medical Group, Division of Surgical Specialties, Grand Rapids, MI, USA.
authors.forename: Mathew H
authors.initials: MH
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000379:methods*; D001063:Appendiceal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Appendiceal abscess; Appendiceal cancer; Appendicitis; Interval appendectomy; Neoplasm; Perforated appendicitis