Treatment of Carcinoid of Appendix When the Tumor Is 2 cm or Larger in Diameter

Appendiceal neuroendocrine tumors (carcinoid of appendix) measuring 2 cm or larger carry a substantially higher risk of nodal spread than smaller lesions, and require a more extensive surgical approach than simple appendectomy alone.

Clinical Scenario

This protocol applies to appendiceal neuroendocrine tumors 2 cm or larger in diameter — a size threshold at which the risk of nodal metastases is high enough to change the recommended surgical strategy.

Management Approach

For tumors of this size, a right-sided surgical resection that includes formal lymph node management is recommended. The full protocol specifies the exact procedure, criteria, and clinical decision points involved.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1007/s11864-023-01093-0

Simple appendectomy is curative for appendiceal NETs (G1–G2) < 1 cm (if the resection status is R0), whereas RHC with lymph node dissection is recommended in tumors ≥ 2 cm in diameter, based on the high risk of nodal metastases in these cases.

View source ↗