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The association between appendicitis severity and patient age with appendiceal neoplasm histology-a population-based study

Paajanen Hannu; Rautio Tero; Grönroos Juha M; Mecklin Jukka-Pekka; Lietzen Elina; Rantanen Tuomo; Sand Juhani; Nordstrom Pia; Salminen Paulina; Leppäniemi Ari; Alajääski Jenny; Ollila Helena

The association between appendicitis severity and patient age with appendiceal neoplasm histology-a population-based study

Paajanen Hannu
Rautio Tero
Grönroos Juha M
Mecklin Jukka-Pekka
Lietzen Elina
Rantanen Tuomo
Sand Juhani
Nordstrom Pia
Salminen Paulina
Leppäniemi Ari
Alajääski Jenny
Ollila Helena
Katso/Avaa
AlajääskiEtAl2022TheAssociationBetweenAppendicitis.pdf (636.5Kb)
Lataukset: 

SPRINGER
doi:10.1007/s00384-022-04132-8
URI
https://doi.org/10.1007/s00384-022-04132-8
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Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2022081154136
Tiivistelmä

Purpose

Recent studies have reported alarming appendiceal tumor rates associated with complicated acute appendicitis, especially in patients presenting with a periappendicular abscess. However, the data on histology of appendiceal tumors among acute appendicitis patients is limited, especially in patient cohorts differentiating between uncomplicated and complicated acute appendicitis. We have previously reported the association of increased appendiceal tumor prevalence with complicated acute appendicitis in this population-based study. The objective of this secondary analysis was to evaluate the association of both appendicitis severity and patient age with appendiceal tumor histology.

Methods

This nationwide population-based registry study (The Finnish Cancer Registry) was conducted from 2007 to 2013. All appendiceal tumors (n = 840) and available medical reports (n = 504) of these patients at eight study hospitals were previously evaluated, identifying altogether 250 patients with both acute appendicitis and appendiceal tumor.

Results

The severity of acute appendicitis was significantly associated with more malignant tumor histology. The risk of adenocarcinoma or pseudomyxoma was significantly higher among patients with periappendicular abscess (OR 15.05, CI 95% 6.98-32.49, p < 0.001) and patients presenting with perforated acute appendicitis (OR 4.09, CI 95% 1.69-9.90, p = 0.0018) compared to patients with uncomplicated acute appendicitis. Similarly, patient age over 40 years was significantly associated with the risk of adenocarcinoma and pseudomyxoma (OR 26.46, Cl 95% 7.95-88.09, p < 0.001). Patient sex was not associated with a more malignant appendiceal tumor histology (p = 0.67).

Conclusion

More malignant appendiceal tumor histology of adenocarcinoma or pseudomyxoma was significantly associated with patient age over 40 years and complicated acute appendicitis, especially periappendicular abscess.

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