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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Comparison of management strategies for neuroendocrine appendix tumors according to different published guidelines

Comparison of management strategies for neuroendocrine appendix tumors according to different published guidelines
  <1 cm 1 to 2 cm >2 cm
TNCD[1] Cured by appendectomy if:
  • R0 (no tumor on margin)
  • Grade 1
Right hemicolectomy if:
  • Base or R1
No recommendation for tumor <1 cm, but grade 2 		Right hemicolectomy if:
  • Base or R1 or lymph node involvement
  • Lymphovascular involvement
  • Invasion of the mesoappendix >3 mm
  • Grade 2
Right hemicolectomy
ENETS[2] Cured by appendectomy if:
  • Tip/body and R0
Right hemicolectomy if:
  • Base or R1
Discuss right hemicolectomy if:
  • Mesoappendix invasion >3 mm
Right hemicolectomy if:
  • Base or R1
Discuss right hemicolectomy if:
  • Tip/middle and R0, but with risk factors (lymphatic invasion, grade 2, or invasion of the mesoappendix >3 mm)
Right hemicolectomy
UKINETS[3] Cured by appendectomy Right hemicolectomy if:
  • Serosal breach by tumor
  • Cellular atypia
  • Mesoappendix invasion >3 mm
  • Base (perforation of the appendix) (lymphovascular and perineural invasion)
Right hemicolectomy
NCCN[4] Cured by appendectomy if:
  • Confined to the appendix (complete resection: nodes, margins)
Right hemicolectomy
NANETS[5] Cured by appendectomy if:
  • Tip
  • Complete tumor resection
  • No lymphovascular involvement
  • No invasion of the mesoappendix
Right hemicolectomy if:
  • Base
  • Incomplete tumor resection
  • Lymphovascular invasion
  • Mesoappendix invasion
  • Intermediate- to high-grade tumor
  • Mesenteric nodal involvement
Right hemicolectomy
TNCD: Thésaurus National de Cancérologie Digestive; R0: indicates negative surgical margin; R1: indicates positive surgical margin; ENETS: European Neuroendocrine Tumor Society; UKINETS: United Kingdom and Ireland Neuroendocrine Tumour Society; NCCN: National Comprehensive Cancer Network; NANETS: North American Neuroendocrine Tumor Society.
References:
  1. Cadiot G, Baudin E, Coriat R, et al. Tumeurs neuro-endocrine. In: Thésaurus National de Cancérologie Digestive, Société Nationale Française de Gastro-Entérologie, 2017.
  2. Pape UF, Niederle B, Costa F, et al. ENETS consensus guidelines for neuroendocrine neoplasms of the appendix (excluding goblet cell carcinomas). Neuroendocrinology 2016; 103:144.
  3. Ramage JK, Ahmed A, Ardill J, et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut 2012; 61:6.
  4. National Comprehensive Cancer Network (NCCN) Guidelines Version 2.2016: Neuroendocrine Tumors of the Gastrointestinal Tract, Lung, and Thymus (Carcinoid Tumors). Available at: https://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site (Accessed 2016).
  5. Boudreaux JP, Klimstra DS, Hassan MM, et al. The NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: well-differentiated neuroendocrine tumors of the Jejunum, Ileum, Appendix, and Cecum. Pancreas 2010; 39:753.
From: Rault-Petit B, Do Cao C, Guyétant S, et al. Current management and predictive factors of lymph node metastasis of appendix neuroendocrine tumors: A national study from the French Group of Endocrine Tumors (GTE). Ann Surg 2019; 270:165. DOI: 10.1097/SLA.0000000000002736. Copyright © 2019. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.
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