Non-metastatic epithelial tumors of the appendix: Management after appendectomy

HAMN: high-grade appendiceal mucinous neoplasm; LAMN: low-grade appendiceal mucinous neoplasm.

* LAMN and HAMN are mucinous appendiceal neoplasms that are dysplastic but noninvasive (ie, do not penetrate into the muscularis propria).

¶ Goblet cell adenocarcinomas have dominant histopathologic features of adenocarcinoma (mucin-secreting cells) and a minor component of neuroendocrine cells.

Goblet cell adenocarcinoma of the appendix is classified and staged as an appendiceal carcinoma since its clinical behavior is more aggressive than that of a neuroendocrine neoplasm.

Δ The posttreatment surveillance of appendiceal adenocarcinoma generally follows the guidelines for posttreatment surveillance of colorectal cancer.

For specific posttreatment surveillance schedules for LAMN and HAMN, refer to the UpToDate content on appendiceal mucinous tumors.

◊ Patients with invasive adenocarcinoma or goblet cell adenocarcinoma who undergo right completion hemicolectomy are evaluated for adjuvant chemotherapy using a similar approach to resected colon cancer.

For further details, refer to the UpToDate content on epithelial tumors of the appendix, appendiceal mucinous tumors, and adjuvant therapy for resected stage II and III colon cancer.