Performing Routine Appendectomy in Mucinous Borderline Ovarian Tumours: An Experience of 15 Years From a Cancer Centre

Background: It is very controversial whether appendectomy should be performed as a routine part of the staging procedure for mucinous borderline ovarian tumours (mBOTs) or not, as the involvement of the appendix in women undergoing surgery for mBOTs and the exact magnitude of the benefit of appendectomy are unclear. This study was conducted to determine the frequency of appendiceal involvement in patients of mBOTs and morbidity associated with surgery and to evaluate recurrence-free survival after surgery. Methods: This retrospective cohort study was conducted at a cancer centre from January 2008 to December 2022 (15 years). The hospital database was searched for patients whose final diagnosis was mBOTs. All women who have been operated for mBOTs were included in the study. Descriptive analysis was performed for study variables. The survival curve was calculated according to the Kaplan-Meier method. Results: Ninety cases whose final diagnosis was mBOTs were identified from the Cancer Registry. Of those, 39 cases were excluded as they did not fulfil the inclusion criteria. Fifty-one patients were finally selected for the study. Of the 51 patients, appendectomy was not performed in eight patients, and the reason was not mentioned in the hospital record. The appendix was macroscopically abnormal in only two patients. None of the patients was diagnosed with mucinous borderline tumours of the appendix in our study. The appendectomy itself was not associated with any complications. Only one patient with mBOT had recurrence after four months of surgery, which was surgically treated and no patient died during the median follow-up of 36 months. Conclusion: If the appendix is grossly normal looking, then appendectomy can be omitted in surgery of mBOTs. mBOTs have good recurrence free and overall survival outcomes post surgery.