APPENDECTOMY IN THE SURGICAL STAGING OF OVARIAN-CARCINOMA

Objectives: Extensive debulking is accepted as the primary method of o perative management for carcinoma of the ovary. However, there is no c onsensus regarding the role of appendectomy in primary surgical treatm ent. The aim of this study was to assess the role of appendectomy in t he surgical staging and cytoreduction of ovarian carcinoma. Methods: T he study was a retrospective review of 90 primary malignant ovarian ca rcinoma patients who had an appendectomy in addition to primary cytore ductive surgery. Results: Out of 90 patients, 10 (11.1%) had metastasi s to the appendix, The rate of metastasis to the appendix was 11.5% (9 /78) in malignant epithelial ovarian carcinomas and 8.3% (1/12) in non -epithelial ovarian tumors. Of the patients with metastasis in the app endix, malignant epithelial ovarian tumors were identified in 90% (ser ous: 70%; clear cell: 20%), and non-epithelial malignant ovarian tumor were disclosed in 10% (granulosa cell carcinoma). There were no metas tases to the appendix in the other histological types. Although metast asis to the appendix was not observed in early stage ovarian carcinoma s, it was detected in 21.4% (9/42) of stage III and 50% (1/2) of stage IV. Macroscopic tumor metastasis in the abdomen was noted in all pati ents with metastasis to the appendix. Conclusion: Appendectomy for sta ge I and II patients was not beneficial and did not affect final stagi ng. As a result, for the proper staging of ovarian carcinoma there is no advantage to the addition of routine appendectomy to primary cytore ductive surgery in early stage (stage I and II) malignant epithelial o varian tumors. Appendectomy would contribute to the cytoreduction of a dvanced stage disease if it is macroscopically involved.