Appendiceal Carcinoid Tumors: Predictors of Lymph Node Metastasis and the Impact of Right Hemicolectomy on Survival

Background and Objectives: Given the lack of population-based data in the literature, we sought to (1) identify predictors of appendiceal carcinoid tumor nodal metastasis to distinguish which patients would most likely benefit from hemicolectomy and (2) compare survival after hemicolectomy versus appendectomy alone. Methods: Using the Surveillance Epidemiology and End Results Database (1988-2005), we identified patients with appendiceal carcinoid tumors who underwent resection. We identified risk factors for nodal metastasis using logistic regression models and used the Kaplan-Meier method to compare adjusted overall and cancer-specific survival after right hemicolectomy versus appendectomy alone. Results: 576 patients met our inclusion criteria. We found that tumor size (>2.0 cm) and tumor histology (pure carcinoid tumors) were significant predictors of lymph node metastasis. After stratifying by tumor size, we did not detect a significant difference in survival between patients who underwent hemicolectomy and those that underwent appendectomy alone (log-rank, P > 0.10). Conclusions: Tumor size and histology are significant predictors of appendiceal carcinoid tumor nodal metastasis and therefore may be helpful to identify which patients would most likely benefit from a hemicolectomy. However, our population-based study did not demonstrate a significant difference in adjusted survival rates between hemicolectomy versus appendectomy alone. J. Surg. Oncol. 2011; 103: 39-45. (c) 2010 Wiley-Liss, Inc.