异质命名法描述阑尾肿瘤已增加对其适当治疗的不确定性。尽管最近达成共识使用术语低级别阑尾肿瘤(LAMN)，我们假设在LAMN的治疗中仍存在显著差异。我们回顾性地审查了我们追踪记录的阑尾登记册，从2009年至2019年识别出LAMN患者。我们评估了治疗的变异性，包括患者是否接受结肠切除术，在疾病初现时的病情扩散以及长期预后。 在136例LAMN患者中，88例(35%)表现为局限性疾病，48例(35%)表现为弥散性腹膜疾病。中位随访时间为2.9年(IQR 1.9-4.4)，120例(88%)患者接受了转诊前的手术。在26例转诊前结肠切除患者中，23例(88%)是出于感知的肿瘤需求/淋巴结评估进行的；未发现淋巴结转移。对于没有弥散性疾病放射学表现的切除的LAMN患者，47%(41例)接受了第二次观察性腹腔镜检查(DL)以评估隐匿转移瘤。未发现腹膜转移瘤。弥散性疾病患者接受了减容性手术/加热腹腔化疗(CRS/HIPEC)。对于接受CRS/HIPEC的患者，5年无复发生存率为94%(95% CI 81-98%)。对于局限性疾病的患者，5年无复发生存率为98%(95% CI 85-99%)。 LAMN的治疗方案存在显著差异，尤其是在转诊至高负荷中心之前。患者经常接受结肠切除术，但并无明显的肿瘤益处。在目前高质量的断层成像时代，例行使用DL的产出较低，不推荐使用。该人群的复发率很低，可以提供低强度监测。总体预后良好，即使出现腹膜疾病也是如此。 © 2023. Society of Surgical Oncology.

Heterogenous nomenclature describing appendiceal neoplasms has added to uncertainty around their appropriate treatment. Although a recent consensus has established the term low-grade appendiceal neoplasm (LAMN), we hypothesize that significant variation remains in the treatment of LAMNs.We retrospectively reviewed our prospectively maintained appendiceal registry, identifying patients with LAMNs from 2009 to 2019. We assessed variability in treatment, including whether patients underwent colectomy, spread of disease at presentation, and long-term outcomes.Of 136 patients with LAMNs, 88 (35%) presented with localized disease and 48 (35%) with disseminated peritoneal disease. Median follow-up was 2.9 years (IQR 1.9-4.4), and 120 (88%) patients underwent pre-referral surgery. Among 26 pre-referral colectomy patients, 23 (88%) were performed for perceived oncologic need/nodal evaluation; no nodal metastases were identified. In patients with resected LAMNs without radiographic evidence of disseminated disease, 41 (47%) underwent second look diagnostic laparoscopy (DL) to evaluate for occult metastases. No peritoneal metastases were identified. Patients with disseminated disease were treated with cytoreductive surgery/heated intraperitoneal chemotherapy (CRS/HIPEC). For patients undergoing CRS/HIPEC, 5-year recurrence-free survival was 94% (95% CI 81-98%). For patients with localized disease, 5-year RFS was 98% (95% CI 85-99%).Significant variation exists in treatment patterns for LAMNs, particularly prior to referral to a high-volume center. Patients frequently underwent colectomy without apparent oncologic benefit. In the current era of high-quality cross sectional imaging, routine use of DL has low yield and is not recommended. Recurrence in this population is rare, and low-intensity surveillance can be offered. Overall prognosis is excellent, even with peritoneal disease.© 2023. Society of Surgical Oncology.