Oncologic Implications of Nonoperative Appendicitis Treatment
Menée en France à partir de données portant sur 2 293 appendicectomies réalisées pour une appendicite aiguë entre 2013 et 2021, cette étude examine la prévalence et les caractéristiques histopathologiques des néoplasmes appendiculaires découverts fortuitement puis identifie les facteurs radiologiques et cliniques préopératoires associés au diagnostic de tumeur agressive
With great interest, we read the article by Germes et al. In their single-center, retrospective cohort study including 2293 appendectomies, the authors reported incidental appendiceal tumors in 37 patients (1.6%); these were predominantly small (<2 cm) grade 1 (G1) neuroendocrine tumors (NETs) (22 patients [59%]). Aggressive malignancies were rare and could be effectively excluded using simple criteria: age younger than 60 years, symptom duration less than 14 days, absence of radiological signs of complicated appendicitis, appendiceal diameter less than 15 mm, and absence of suspicious appendiceal, peritoneal, hepatic, or bone lesions. Small G1 NETs and low-grade dysplastic polyps remained indistinguishable from benign appendicitis, but their malignant potential was considered generally low. We would like to reflect on the main findings.
JAMA Surgery , éditorial, 2026