title: Should we remove the normal-looking appendix during operations for borderline mucinous ovarian neoplasms?: A retrospective study of 129 cases.
abstract: BACKGROUND
  The aim of this study was to determine how often the appendix is involved or the primary source of cancer in women undergoing surgery for mucinous borderline ovarian tumour (mBOT) or invasive mucinous ovarian tumour (IMOT) and to evaluate whether appendectomy is necessary.
  
  
  METHODS
  The hospital database was searched for women who underwent surgery and whose final diagnosis was mBOT, IMOT or mucinous appendix carcinoma between 1998 and 2014.
  
  
  RESULTS
  One hundred and twenty-nine cases were identified, including 69 mBOT, 51 IMOT and nine primary mucinous appendix carcinomas. Of 97 appendectomies performed, nine lymphoid hyperplasia, two mucocele, one carcinoid tumour of the appendix, one mucinous tumour metastasis from the ovary and nine primary mucinous appendix carcinomas were found and all appendices were grossly abnormal. No recurrence was seen during the follow-up period in 28 patients who had no appendectomy performed for grossly normal appendix. Pathologic diagnosis was normal in all 65 patients whose appendix was noted to be grossly normal and who underwent appendectomy. No recurrence was detected during a median follow-up period of 7 years (range 1-16 years).Sensitivity, specificity, positive and negative predictive value of the macroscopic appearance of the appendix were 100%, 86.67%, 56.52% and 100.00%, respectively.
  
  
  CONCLUSIONS
  If the appendix is grossly normal, it appears unnecessary to perform an appendectomy in patients operated for an adnexal mass and whose frozen section analysis was reported as mBOT or IMOT.
  
  
  CONCLUSIONS
  Appendectomy should not be performed if the appendix is grossly normal.
authors.affiliation: Department of Gynecologic Oncology, Tepecik Research and Training Hospital, Izmir, Turkey. Electronic address: opdraykutozcan@gmail.com.
authors.forename: Aykut
authors.initials: A
authors.lastname: Ozcan
authors.affiliation: Department of Gynecologic Oncology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Töz
authors.affiliation: Department of Gynecologic Oncology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Turan
authors.affiliation: Department of Gynecologic Oncology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors.forename: Cagdas
authors.initials: C
authors.lastname: Sahin
authors.affiliation: Department of Gynecologic Oncology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors.forename: Aycan
authors.initials: A
authors.lastname: Kopuz
authors.affiliation: Department of Gynecologic Oncology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Ata
authors.affiliation: Department of Gynecologic Oncology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Sancı
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D001062:Appendectomy; D001063:Appendiceal Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D001065:Appendix / Q000473:pathology*; D005260:Female; D005629:Frozen Sections; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000601:surgery; D010051:Ovarian Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D019564:Unnecessary Procedures
keywords: Appendectomy; Invasive mucinous ovarian tumour; Mucinous borderline ovarian tumour; Primary mucinous appendix carcinoma