Comparison between early surgical treatment and conservative treatment of appendicitis in cancer patients

• Published in: ANZ journal of surgery Vol. 91; no. 10; pp. 2067 - 2073
• Main Authors: Park, Sin Hye, Park, Sung Sil, Lee, Dong Woon, Park, Hyoung‐Chul, Park, Sung Chan, Hong, Chang Won, Sohn, Dae Kyung, Han, Kyung Su, Chang, Hee Jin, Oh, Jae Hwan
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.10.2021; Blackwell Publishing Ltd
• Subjects: Antibiotics; appendectomy; Appendicitis; Cancer; conservative treatment; Intravenous administration; Patients; Surgery; Tumors
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/ans.17180

Backgrounds In cancer patients, the optimal appendicitis treatment has not been established. Therefore, we aimed to determine the ideal treatment option for appendicitis in cancer patients. Methods This retrospective study included 185 cancer patients with acute appendicitis who were divided into the early surgical group (n = 152) involving surgery performed within 48 h following the appendicitis diagnosis or the conservative group (n = 33) involving intravenous antibiotics. We compared the appendicitis treatment efficacy between the groups. Results In the early surgical group, the antibiotic duration [5.5 days (4.0–8.0) vs. 17.0 days (12.5–25.0), p < 0.001] and hospital stay length [7.0 days (5.0–11.75) vs. 10.0 days (8.0–32.0), p < 0.001] were significantly shorter. Regarding pathology, 16/171 (9.4%) patients who underwent surgery exhibited appendiceal tumours. During the 1‐year follow‐up period, one recurrence occurred in each group [1/152 (0.7%) vs. 1/33 (3.0%), p = 0.326]. The 1‐year treatment success rate was higher in the early surgical group [99.3% (151/152) vs. 42.4% (14/33), p < 0.001]. Conclusion Early surgical treatment yielded a significantly higher success rate than conservative treatment for appendicitis in cancer patients. Surgery for appendicitis in cancer patients should be considered not only for treatment but also for pathologic confirmation. Early surgical treatment resulted in a higher treatment success rate for appendicitis in cancer patients compared to conservative treatment. Surgery for appendicitis in cancer patients should be performed not only for controlling the inflammatory process but also for a definite pathologic confirmation.