Appendectomy vs Right Hemicolectomy for Pediatric Neuroendocrine Tumor of the Appendix in a National Cohort: A Call to Further Decrease Colectomy
Topic overview
National cohort study of 1,339 pediatric patients demonstrates that appendectomy alone achieves excellent 5-year survival (99.9%) for appendiceal neuroendocrine tumors, even with positive margins. Right hemicolectomy offers no survival benefit and should be avoided in children, contrary to adult treatment guidelines.
Key takeaways
- Appendectomy alone is safe and effective for pediatric appendiceal NETs, even with positive margins—no survival benefit from right hemicolectomy
- 5-year survival for pediatric appendiceal NET after appendectomy is 99.9%, regardless of tumor size, margins, or lymph node status
- 14% of children still undergo unnecessary right hemicolectomy based on adult guidelines—pediatric-specific approach should be standard
- Positive margins on appendectomy do not warrant additional resection in children with appendiceal neuroendocrine tumors
- Lymph node assessment and extended resection add morbidity without improving outcomes in pediatric appendiceal NET
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