A scoping review of postoperative surveillance strategies for localized, low-grade appendiceal mucinous neoplasms

• Published in: The American journal of surgery Vol. 242; p. 116202
• Main Authors: Oravec, Nebojša, Mack, Lloyd, Hallock, Dara, McClurg, Caitlin, Quan, May Lynn
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2025; Elsevier Limited
• Subjects: Adenocarcinoma, Mucinous - diagnosis; Adenocarcinoma, Mucinous - mortality; Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Mucinous - surgery; Appendectomy; Appendiceal Neoplasms - diagnosis; Appendiceal Neoplasms - mortality; Appendiceal Neoplasms - pathology; Appendiceal Neoplasms - surgery; Appendix; Biomarkers; Citation management software; Disease-Free Survival; Humans; LAMN; Laparoscopy; Low-grade; Medical prognosis; Metastasis; Mucinous; Neoplasm Grading; Neoplasm Recurrence, Local; Neoplasms; Oncology; Postoperative; Surgery; Surveillance; Survival; Tumors; Postoperative; Mucinous; Surveillance; LAMN; Low-grade; Appendix
• ISSN: 0002-9610; 1879-1883; 1879-1883
• DOI: 10.1016/j.amjsurg.2025.116202

There is a paucity of data to support surveillance protocols for localized, low-grade appendiceal mucinous neoplasms (LAMNs) after resection. A search strategy was developed to identify postoperative surveillance strategies for LAMNs, in the context of rates of recurrence and disease-free survival, and applied to four literature databases. Resultant citations were subject to screening in duplicate, in three stages: title, abstract, and full-text. Data was extracted from the final set of included articles and subject to descriptive statistics. A total of 16 articles, representing 1218 patients, were included. The duration of surveillance ranged from 0.1 to 294 months, and the mode surveillance interval was three months. The most common surveillance method was imaging (n ​= ​610 patients, 48.7 ​%). Thirty one patients had disease recurrence (2.7 ​%). Time to recurrence ranged from 2.5 to 68 months, and the range of five-year survival was 93.5–95.2 ​% among five studies. In the absence of strong evidence to suggest that surveillance confers a survival benefit for patients with localized LAMNs after resection, decisions about surveillance should be patient-oriented. •There is considerable practice variability in surveillance for localized, low-grade LAMNs after resection.•There is no strong evidence to suggest that surveillance confers a disease-free survival benefit for patients with localized, non-perforated LAMN resected with negative margins.•Decisions about surveillance should be patient-oriented, and informed by the patient's individual risk tolerance.