Therapy of appendix cancer

In most cases, appendicitis is treated in the same way as colorectal cancer. If the tumour is localised or the spread (metastases) can be treated, surgery would be the first step. The right part of the colon is removed, a so-called right hemicolectomy is performed.

During this procedure, one also tries to remove the local lymph nodes in order to prevent scattering. The operation is performed minimally invasive (laparoscopic) if possible. .

Depending on the stage of the tumor disease, additional chemotherapy is given. If the tumour has already spread into the abdominal cavity, a hemicolectomy is also performed on the right side, in which the peritoneum is also removed. In addition, the abdomen is rinsed with a chemotherapeutic agent.

No radiation therapy is performed on the intestine. In the case of a neuroendocrine tumour (NET), the appendix and local lymph nodes would also be removed surgically. In the case of very advanced findings, where there is no option for surgery, drugs such as somatostatin analogues are given.

In some cases, chemotherapy is also necessary here. As with normal colorectal cancer, chemotherapy may be considered for appendix cancer from stage II onwards. The stages are divided according to the size of the tumour and its spread.

In most cases, an interdisciplinary decision is made on the basis of all examinations as to whether this therapy is appropriate. In stage II, monotherapy, i.e. therapy with a single chemotherapeutic agent, would be considered. Fluoropyrimidines are usually used for this.

From stage III on, combination therapies are considered. One can give the so-called FOLFOX (5-FU+folinic acid+oxaliplatin) or the combination XELOX (capecitabine+oxaliplatin). For poorly differentiated neuroendocrine tumours (NET), chemotherapy with cisplatin and etoposide can be given. Learn more about chemotherapy for colorectal cancer.

What is the course of the disease?

The course of the disease depends on the stage of the colon cancer. If the findings are small, surgery is sufficient and the chances of recovery are very high. In case of scattering in the lymph nodes or other organs, chemotherapy is necessary within 8 weeks after the operation.

In some cases, spread of the tumour to other organs, for example the liver, can also be operated on. If the appendix cancer has reached the peritoneum and has spread there, this can lead to adhesions in the intestine. These complications must be treated surgically.

Such a case has a bad prognosis. Let us explain the course of bowel cancer in more detail. Metastases are spread of the tumour via the bloodstream, the lymphatic system or neighbouring tissue.

Appendicitis can attack neighbouring tissue and, if the appendix bursts, spread into the abdomen. Other structures that can be affected early on are the local lymph nodes that carry the lymph away from the appendix. The tumour can enter the liver, lungs, skeleton and brain via the blood. The metastases are usually treated with chemotherapy and in some cases can be operated on.