Ann Surg Treat Res.  2024 Jul;107(1):1-7. 10.4174/astr.2024.107.1.1.

Treatment for appendicitis in cancer patients on chemotherapy: a retrospective cohort study

• Kim HH
• Park SS
• Kim BC
• Han KS
• Kim B
• Hong CW
• Sohn DK
• You K
• Lee DW
• Park SC

• KMID: 2557574
• DOI: http://doi.org/10.4174/astr.2024.107.1.1

Abstract

Purpose
Whether to perform surgery or conservatively manage appendicitis in immunosuppressed patients is a concern for clinicians. This study aimed to compare the outcomes of these 2 treatment options for appendicitis in patients with cancer undergoing chemotherapy.
Methods
This retrospective study included 206 patients with cancer who were diagnosed with acute appendicitis between August 2001 and December 2021. Among them, patients who received chemotherapy within 1 month were divided into surgical and conservative groups. We evaluated the outcomes, including treatment success within 1 year, 1-year recurrence, and the number of days from the diagnosis of appendicitis to chemotherapy restart, between the 2 groups.
Results
Among the 206 patients with cancer who were diagnosed with acute appendicitis, 78 received chemotherapy within 1 month. The patients were divided into surgery (n = 63) and conservative (n = 15) groups. In the surgery group, the duration of antibiotic therapy (7.0 days vs. 16.0 days, P < 0.001) and length of hospital stay (8.0 days vs. 27.5 days, P = 0.002) were significantly shorter than conservative groups. The duration from the diagnosis of appendicitis to the restart of chemotherapy was shorter in the surgery group (20.8 ± 15.1 days vs. 35.2 ± 28.2 days, P = 0.028). The treatment success rate within 1 year was higher in the surgery group (100% vs. 33.3%, P < 0.001).
Conclusion
Surgical treatment showed a significantly higher success rate than conservative treatment for appendicitis in patients less than 1 month after chemotherapy. Further prospective studies will be needed to clinically determine treatment options.

Keyword

Appendicitis; Surgery; Conservative treatment; Neoplasms; Drug therapy

Figure

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  Fig. 1 Study flowchart.

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