Department of Surgery, Division of Surgical Oncology, Swedish Medical Center, 747 Broadway, Heath 10, Suite 1003, Seattle, WA, 98122, USA.
Am J Surg. 2022 Jun;223(6):1183-1186. doi: 10.1016/j.amjsurg.2021.12.003. Epub 2021 Dec 3.
The discovery of a low grade appendiceal mucinous neoplasm (LAMN) during appendectomy is a rare scenario. These neoplasms can progress to pseudomyxoma peritonei (PMP), however the incidence of progression is not well known.
The records of all patients with a diagnosis of localized LAMN found during appendectomy were identified, and demographic, tumor, surveillance, and outcome variables were analyzed.
Progression to PMP occurred in 20% of patients in an average of 12.4 months after appendectomy with median follow-up of 18 months. Tumor variables such as margin positivity, appendiceal perforation, and presence of extra-appendiceal acellular mucin or mucinous epithelium on the serosal were not significantly associated with progression.
During an average follow-up period of 18 months after surgery, progression to PMP occurred in a fifth of patients. It is difficult to predict which patients will progress, therefore cross-sectional imaging surveillance is recommended for all patients.
在阑尾切除术中发现低度阑尾粘液性肿瘤（LAMN）是一种罕见情况。这些肿瘤可能进展为腹膜假性粘液瘤（PMP），但进展的发生率尚不清楚。
确定了在阑尾切除术中发现的局限性 LAMN 患者的所有记录，并分析了人口统计学、肿瘤、监测和结果变量。
在阑尾切除术后平均 12.4 个月，20%的患者进展为 PMP，中位随访时间为 18 个月。肿瘤变量如边缘阳性、阑尾穿孔以及浆膜上存在额外阑尾无细胞粘液或粘液上皮与进展无显著相关性。
在手术后平均 18 个月的随访期间，五分之一的患者进展为 PMP。很难预测哪些患者会进展，因此建议对所有患者进行横断面成像监测。
