The role of appendectomy in patients with mucinous borderline ovarian tumors

Objectives: To determine the frequency of appendiceal involvement in patients undergoing surgery for mucinous borderline ovarian tumors (mBOTs), and to evaluate the associated morbidity, and the recurrence risk and survival after appendectomy. Study Design: The hospital databases were searched for women who underwent adnexal surgery at the Department of Obstetrics and Gynecology of four Korean academic hospitals, and whose final or frozen diagnosis was mBOTs. A literature search was performed, using electronic database (MEDLINE and EMBASE), to assess the available evidence on performing an appendectomy in patients with mBOTs. Results: Of the 473 included patients with mBOTs, 201 (42.5%) underwent appendectomy, 247 (52.2%) did not undergo appendectomy at the time of initial surgery, and 25 (5.3%) had previously undergone appendectomy. Among the 201 patients who underwent appendectomy, primary and metastatic appendiceal mucinous neoplasms were occurred in 1 patient each (0.5%), who showed a macroscopically abnormal appendix. Appendectomy itself was not associated with operative complications (P = 0.082), recurrence risk (P = 0.964), or survival (P = 0.219). Consistent with our findings, a comprehensive search of the literature revealed that the frequency of appendiceal involvement in mBOTs was less than 1% in either primary or metastatic appendiceal neoplasms. Conclusions: If the appendix is grossly normal, an appendectomy seems unnecessary in patients with mBOTs. However, a careful intra-operative exploration of the appendix is essential. (C) 2018 Published by Elsevier B.V.