Omitting hemicolectomy for patients with appendiceal neuroendocrine tumours of 1-2 cm

We read the Article by Cédric Nesti and colleagues 1 Nesti C Bräutigam K Benavent M et al. Hemicolectomy versus appendectomy for patients with appendiceal neuroendocrine tumours 1–2 cm in size: a retrospective, Europe-wide, pooled cohort study. Lancet Oncol. 2023; 24: 187-194 Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar in The Lancet Oncology with great interest. We believe the retrospective data used in the study might not be strong enough to offer a strict revision in the guidelines because of a few parameters we highlight here. Hemicolectomy versus appendectomy for patients with appendiceal neuroendocrine tumours 1–2 cm in size: a retrospective, Europe-wide, pooled cohort studyThis study provides evidence that right-sided hemicolectomy is not indicated after complete resection of an appendiceal NET of 1–2 cm in size by appendectomy, that regional lymph node metastases of appendiceal NETs are clinically irrelevant, and that an additional postoperative exclusion of metastases and histopathological evaluation of risk factors is not supported by the presented results. These findings should inform consensus best practice guidelines for this patient cohort. Full-Text PDF Omitting hemicolectomy for patients with appendiceal neuroendocrine tumours of 1–2 cmWe read with great interest the Article by Cédric Nesti and colleagues1 in The Lancet Oncology on their commendable effort to investigate the value of right-sided hemicolectomy compared with appendectomy in appendiceal neuroendocrine tumours (NETs) of 1–2 cm, using data from 278 patients from across 40 hospitals in 15 European countries. Despite the available evidence in appendiceal NETs being limited to retrospective series due to their rarity and relatively indolent behaviour, appendiceal NETs smaller than 1 cm are considered cured by appendectomy, whereas those larger than 2 cm need completion by right-sided hemicolectomy. Full-Text PDF Omitting hemicolectomy for patients with appendiceal neuroendocrine tumours of 1–2 cmWe read with great interest the Article by Cédric Nesti and colleagues1 reporting outcomes of patients with resected appendiceal neuroendocrine tumours (NETs). After a median follow-up of 13 years, there was no difference in overall survival between patients who had a simple appendectomy and those who had a completion right-sided hemicolectomy. The authors rightly suggest that a right-sided hemicolectomy is not indicated for patients with small appendiceal NETs and a simple appendectomy suffices as surgical therapy. Full-Text PDF Omitting hemicolectomy for patients with appendiceal neuroendocrine tumours of 1–2 cm – Authors' replyWe appreciate the Correspondences from Thorvardur R Halfdanarson and colleagues, Giuseppe Lamberti and colleagues, and Melik Kagan Aktas and colleagues on our retrospective, Europe-wide study comparing hemicolectomy with appendectomy for patients with appendiceal neuroendocrine tumours (NETs) of 1–2 cm.1 Full-Text PDF