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Adenocarcinoma of Appendix. A twelve year experience from a cancer hospital in Pakistan.

Masood ur Rehman, Osama Shakeel, Awais Amjad Malik, Sadaf Batool, Abdul Wahid Anwer, Irfan Ul Islam Nasir, Muhammad Asif Noor, Aamir Ali Syed, Shahid Khattak.




Abstract
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Objective: To study the surgical and oncological outcome of all the patients presenting with a diagnosis of carcinoma of the appendix at Shaukat Khanum Memorial Cancer Hospital And Research Centre (SKMCH&RC).
Methodology: From 2006 to 2017, all patients with a diagnosis of carcinoma of the appendix were included in the study. Demographic variables were collected. Surgical outcomes in terms of operation performed and its complications were recorded. Short and long term oncological outcomes were recorded. All data were entered and analyzed in SPSS version 21.
Results: A total of 19 patients were included in the study. The median age was 54.8 +/- 2.9 years. There were 7 male and 12 female patients. The most common presentation was a pain in the right iliac fossa in 16 patients followed by altered bowel habits in 3 patients. 15 patients were diagnosed after they had their operation. 13 had an open appendectomy and 2 had a total abdominal hysterectomy with appendectomy. Open appendectomy was performed in 68.4% (n=13) of the patients, right hemicolectomy in 21.1% (n=4) patients. 12 patients received adjuvant chemotherapy. 6 patients had a disease recurrence. All patients had a median survival of 50 months.
Conclusion: Cancer of the appendix is rare and needs to be managed aggressively. All patients are best treated with a formal right hemicolectomy with adjuvant chemotherapy.

Key words: Carcinoma Appendix, appendicular cancer, adenocarcinoma, neuroendocrine cancer, lower middle-income country






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