Simple appendectomy is a safe and effective surgical approach for low-grade appendiceal mucinous neoplasm at the appendiceal root with negative margins: a retrospective comparative cohort study

Abstract Background Appendiceal tumors are very rare among gastrointestinal tumors. Based on low-grade appendiceal mucinous neoplasm (LAMN) unique biological behavior and clinical characteristics, we hope to evaluate the safe surgical approach for LAMN at the root of the appendix. Method Collect and review the anthropological data of patients from January 1, 2013 to January 1, 2025. The patients were grouped according to different surgical methods, and the demographic data, anthropological characteristics, treatment plans and prognosis of the patients were compared and analyzed. Result A total of 97 patients were included in this study. Among them, 54 patients underwent simple appendectomy(SA), and 43 patients were in extended surgical resection (ESR) group (including partial cecectomy, ileocecal resection, right hemicolectomy, etc.). The average [SD] age in the SA group was 54.14[15.7] years, with 35 females [64.8%]. The incidence of postoperative complications in the SA group was 11.1%, which was significantly lower than 27.9% in ESR group, with a statistically significant difference (P = 0.040); however, there was no significant difference in the distribution of complication severity between the two groups. In addition, patients in the SA group achieved more rapid postoperative recovery. Following the exclusion of patients who had positive margins or tumor perforation, survival analysis results showed that there were no statistically significant differences in 5-year and 10-year overall survival (OS) rates or 5-year and 10-year recurrence-free survival (RFS) rates between the two groups. Conclusion For patients with LAMN at the root of the appendix, simple appendectomy is a safe and effective surgical approach.