Concurrent Appendectomy in Patients Undergoing Surgery for Gynecological Malignancies: A Retrospective Analysis from a Tertiary Referral Center.

Abstract

Objectives: To evaluate appendectomy specimen findings and their association with tumor type and stage. Concurrent appendectomy is frequently performed during gynecologic oncology surgery to prevent postoperative appendicitis and detect occult pathology, yet its value remains debated.

Methods: In this study, we reviewed the medical records of 300 women who underwent gynecologic oncologic surgery accompanied by appendectomy at Başakşehir Çam and Sakura City Hospital (Istanbul, Türkiye) over the period from July 2020 to April 2025. Clinical, surgical, andhistopathologic data were collected. Appendiceal pathologies were categorized as reactive hyperplasia, chronic inflammation, benign neoplasms, metastatic tumors, or primary. Statistical analyses included chi-square, t-test, and ANOVA.

Results: Participants had an average age of 55.6 ± 13.4 years, and 61.7% of them were postmenopausal. Among ovarian tumors, malignant epithelial lesions represented 54.7% of cases, while borderline tumors accounted for 17.7% and benign tumors for 17%. Histopathology revealed chronic inflammation in 40.7%, reactive changes in 34.3%, metastatic disease in 23.3%, benign neoplasms in 1.3%, and primary malignancy in 0.3%. Metastases occurred only in malignant ovarian tumors (35.7%), predominantly high-grade serous carcinomas (p < 0.001). Borderline and benign tumors were mainly associated with reactive findings, and no metastatic involvement was detected.

Conclusion: Concurrent appendectomy during gynecologic oncology surgery is safe and frequently reveals clinically relevant pathology. Appendectomy should be encouraged during cytoreduction, while its role in benign and early-stage cases warrants further investigation.