Page 49 - World Journal of Laparoscopic Surgery

RESEARCH ARTICLE
The Prevalence of Malignant Tumors of the Appendix in

Patients with a History of Appendectomy and its Association

with Demographic and Laboratory Variables

3
2
1
5
4
Behnam Reza Makhsosi , Fatemeh Darabi , Tara Mazaheri , Mansour Rezaei , Zohair Mazaheri , Alireza Rohban 6
Received on: 01 August 2021; Accepted on: 06 September 2022; Published on: 07 December 2022
AbstrAct
Aim: Appendicitis is one of the major causes of acute abdominal pain and one of the most common reasons for emergency surgery. Studies
have shown that those that have undergone appendectomy are more likely to develop malignant tumors of the appendix. The present study
investigates the prevalence of the appendix’s malignant tumors in patients with a history of appendectomy and its association with demographic
and laboratory variables.
Materials and methods: This study is descriptive, in which 4940 patients with a history of appendectomy between 2011 and 2018 in Imam
Reza Hospital, Kermanshah, Iran, have been studied. Initially, the patients’ medical files were investigated, and the necessary demographic and
laboratory information were extracted. Then, the data were analyzed by descriptive statistics, including mean and variance for quantitative
variables and frequency/percentage plus two-dimensional contingency tables for qualitative variables by SPSS 21.
Results: The mean age of the patients with appendectomy was 25.50 years, and the prevalence of malignant tumors of the appendix in patients
was 0.5%. Overall, 41 cases (0.8%) showed positive pathology regarding the existence of a tumor in the appendix; among them, 26 cases (0.5%)
had malignant types, while 15 cases (0.3%) showed benign types. Out of the 26 cases with the appendix’s malignant tumors, 14 were male
(53.8%), and 12 were female (46.2%). The majority of malignant tumors of the appendix were observed in those above 50 years of age. Among
the malignant tumors, 9 (34.61%) were adenocarcinoma mucinous, 6 (23.07%) were carcinoid, 5 (19.23%) were adenocarcinoma, 5 (19.23%)
were malignant mucocele, and 1 (3.84%) was cystadenoma. The relationship between the number of white blood cells (WBC) and the appendix’s
malignant tumors was significant; the WBC count was significantly lower in those with malignant tumors compared to others. In addition, the
relationship between age and the existence of malignant tumors was significant (p = 0.025); older individuals were significantly more likely
to develop malignant tumors of the appendix compared with younger individuals. The study results did not show any significant relationship
between gender and the presence of malignant tumors of the appendix (p = 0.340).
Conclusion: Concerning the local invasion and distant metastasis of some appendix tumors, follow-up of pathology reports by the patient
(especially older ones) as well as the physician plus post-appendectomy checkup within short and regular time intervals and, if required,
follow-up treatment is essential.
Keywords: Appendicitis, Appendectomy, Iran, Tumors.
World Journal of Laparoscopic Surgery (2022): 10.5005/jp-journals-10033-1530

IntroductIon 1 Department of General Surgery, School of Medicine, Kermanshah
The appendix is an essential organ of the gut-associated lymphoid University of Medical Sciences; Imam Reza Hospital, Kermanshah, Iran
1
tissue system, whose physiological function is mostly unknown. 2 Department of Public Health, Asadabad School of Medical Sciences,
Some hypotheses suggest that the appendix plays a vital role in Asadabad, Iran
2
training, developing, and maturing the immune system. When 3,5 Department of General Surgery, Kermanshah University of Medical
the appendix suffers infection and inflammation, appendicitis Sciences, Kermanshah, Iran
occurs, which is one of the most common acute abdominal diseases 4 Department of Biostatistics and Epidemiology, School of Health, Social
3
requiring surgery. The risk of mortality in acute appendicitis has Development and Health Promotion Research Center, Kermanshah
4
been reported 7–8%. In the United States, around 77,000 people University of Medical Sciences, Kermanshah, Iran
develop appendicitis every year, incurring 680 million dollars to the 6 Department of Rehabilitation Management, School of Rehabilitation
5
government. The incidence of appendicitis throughout the lifetime Sciences, Iran University of Medical Sciences, Tehran, Iran
6
is 8.6% and 6.7% for men and women, respectively. The prevalence Corresponding Author: Tara Mazaheri, Department of General
7
of appendicitis differs across various populations, regions, and ages. Surgery, Kermanshah University of Medical Sciences, Kermanshah,
Although lymphoid hyperplasia and fecalith are the most common Iran, Phone: +98 9188871487, e-mail: Tara.mazaheri.tm@gmail.com
factors underlying acute appendicitis, other factors have also How to cite this article: Makhsosi BR, Darabi F, Mazaheri T, et al. The
been identified, including pinworms and tumors as the etiological Prevalence of Malignant Tumors of the Appendix in Patients with a
8
factors. Despite antibiotic treatment, laparoscopy appendectomy History of Appendectomy and its Association with Demographic and
is established as a standard treatment for acute appendicitis. 9,10 Laboratory Variables. World J Lap Surg 2022;15(3):235–238.
Appendix cancer is very rare, 11,12 yet less than 1% of those Source of support: Nil
experiencing appendectomy have the chance of developing Conflict of interest: None

© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.
org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to
the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.