Background: Neuroendocrine tumors (NET) of the appendix in children and adolescents are rare and mostly detected postoperatively by a histopathological examination. Since the malignant potential of these tumors remains unclear, therapeutic recommendations are not evidence based. The Society of Pediatric Oncology and Hematology (GPOH) has prospectively registered and followed children with appendical NET since 1997 (GPOH-MET trial). The objective of this study was to critically evaluate the therapeutic recommendations for appendical NET in children.
Procedure: Clinical data of 237 children with appendical NET were prospectively analyzed.
Results: The mean age at presentation was 13.0 years, while the mean follow-up time was 2.9 (0.0-12.8) years. The majority of tumors (70.9%) were located at the apex, and were smaller than or equal to 10 mm (72.7%). Tumor size was directly correlated with age. A second operation or primary lymph node sampling was done in 25.3% (N = 60) of the patients, and infiltration of the lymph nodes by tumor cells was found in nine of these patients (15%). All 237 patients are alive without tumor symptoms.
Conclusions: ROC analysis and subsequent calculations identified a tumor size of >15 mm as the optimal cut-off point for the prediction of metastatic spread into the lymph system, with a sensitivity of 77.8% and a specificity of 66.7%. Therefore, secondary right hemicolectomy in completely removed appendical NET is recommended only in tumors >15 mm in size. For incompletely removed tumors ≤15 mm a local follow-up resection with lymph node sampling is recommended.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/pbc.24267 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Improving sonographic visualisation of the appendix in a regional referral hospital.
BMJ Open Qual
January 2025
Quality Improvement Coach, University Hospital of Northern British Columbia, Prince George, British Columbia, Canada.
Ultrasound is a first-line and often preferred imaging modality in the diagnosis of acute appendicitis. When the appendix is not visualised during a dedicated appendix ultrasound study, patients may require a CT study, which uses ionising radiation, or undergo conservative clinical observation with the inherent risk of clinical deterioration, perforation and sepsis. Median baseline data, at our hospital imaging department, revealed a rate of combined normal and abnormal appendix visualisation of 34.
View Article and Find Full Text PDFNomogram prediction model for length of hospital stay following laparoscopic appendectomy in pediatric patients: a retrospective study.
Front Pediatr
December 2024
Department of Pediatric Surgery, Suining Central Hospital, Suining, Sichuan Province, China.
Objective: The aim of this research was to develop and internally validate a nomogram for forecasting the length of hospital stay following laparoscopic appendectomy in pediatric patients diagnosed with appendicitis.
Methods: We developed a prediction model based on a training dataset of 415 pediatric patients with appendicitis, and hospitalization data were collected retrospectively from January 2021 and December 2022. The primary outcome measure in this study was hospital length of stay (LOS), with prolonged LOS defined as admission for a duration equal to or exceeding the 75th percentile of LOS, including the discharge day.
Ultrasonographic characteristics of neonatal appendicitis: a case series.
BMC Pediatr
November 2024
General Surgery Department, Children's Hospital of Soochow University, NO.92, Zhongnan Road, Soochow, 215025, Jiangsu, China.
Background: Neonatal appendicitis is a rare but critical condition that presents diagnostic challenges due to its nonspecific symptoms and clinical manifestations. Early and accurate diagnosis is crucial for reducing the high mortality rates associated with this condition. Abdominal ultrasonography plays a pivotal role in identifying characteristic signs of appendicitis in neonates.
View Article and Find Full Text PDFCollision tumor of the appendix with concomitant cecal adenocarcinoma: A case report and literature review.
Int J Surg Case Rep
December 2024
Department of Surgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia.
Introduction: Collision tumors of the appendix are rare tumors consisting of two distinct pathologies arising from different cell lines simultaneously. The most common type is the coexistence of a neuroendocrine tumor (NET) with a low-grade appendiceal mucinous neoplasm (LAMN). We report a unique case of appendiceal collision tumor with synchronous cecal intra-mucosal carcinoma and pulmonary sarcoidosis.
View Article and Find Full Text PDFFully Automated Detection of the Appendix Using U-Net Deep Learning Architecture in CT Scans.
J Clin Med
October 2024
Department of Computer Engineering, Faculty of Engineering, Bilecik Seyh Edebali University, Bilecik 11230, Türkiye.
The accurate segmentation of the appendix with well-defined boundaries is critical for diagnosing conditions such as acute appendicitis. The manual identification of the appendix is time-consuming and highly dependent on the expertise of the radiologist. In this study, we propose a fully automated approach to the detection of the appendix using deep learning architecture based on the U-Net with specific training parameters in CT scans.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!