Carcinoid Tumor of the Appendix: Treatment and Prognosis

Abstract In a long-term study of 150 unselected patients with carcinoid tumors of the appendix, we found that the neoplasms were usually <1.0 cm in largest dimension and discovered as an incidental finding during surgery performed for other reasons. Metastases were observed with none of the 127 appendiceal carcinoids <2.0 cm in largest dimension, with 3 of the 14 lesions ≥2.0 cm but <3.0 cm in greatest dimension, and with 4 of the 9 lesions ≥3.0 cm. Paradoxically, the patients with the larger tumors and metastases were younger than those with smaller and clinically benign tumors. The median age of patients with tumors ≥2.0 cm was 31 years and that of those with metastases was 29 years, as compared with a median age of 42 years in patients with nonmetastasizing tumors <2.0 cm. We conclude that simple appendectomy is adequate treatment for patients with apparently localized tumors <2.0 cm in largest dimension. We have not observed any recurrences or metastases among 122 such patients followed for a median t...