Treatment of Colonic-Type Adenocarcinoma of the Appendix
Clinical Scenario
This protocol addresses colonic-type adenocarcinoma arising in the appendix — a histological subtype whose workup, staging, and treatment approach mirrors that of colon cancer. For classification purposes, appendix cancers are broadly grouped as colonic-type adenocarcinoma, mucinous adenocarcinoma, goblet cell adenocarcinoma, and neuroendocrine carcinoma; this protocol covers the colonic-type.
Treatment Approach (Summary)
Surgical resection plays a central role, with the extent of the procedure guided by tumor stage and the adequacy of lymph node sampling. Staging imaging is required for higher-stage tumors before the definitive intervention.
The complete staging criteria, surgical decision points, and further management details are available in the full structured protocol.
References
DOI: 10.1055/s-0035-1564433
- For the purposes of this review, appendix cancers will be broadly classified as: colonic-type adenocarcinoma, mucinous adenocarcinoma, goblet cell adenocarcinoma (GCA), and neuroendocrine carcinoma (aka. "typical carcinoid").
- The workup, staging, and treatment of colonic-type adenocarcinoma arising in the appendix mirror that of colon cancer.
- Patients found to have unfavorable T1 tumors (high-grade, angiolymphatic invasion, and/or positive margins) should be considered for formal right hemicolectomy for adequate staging and resection.
- Patients with T2 or greater tumors require complete staging with contrast-enhanced computed tomography (CT) of the chest, abdomen, and pelvis if not already performed.
- If there is no evidence of distant metastasis, right hemicolectomy is recommended, with 12 or more lymph nodes typically considered adequate for accurate staging.
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