Appendiceal (NET) - Recommendation for a right hemicolectomy

Hello everyone,

I would like to share my case and hear from others who may have been in a similar situation.

I am 41 years old and was incidentally diagnosed with an appendiceal neuroendocrine tumor (NET) after an appendectomy performed.

The initial pathology report described some risk factors, but I requested a pathology review at a specialized center. After the review, the final findings were:

* Well-differentiated neuroendocrine tumor (NET G1)
* Tumor size: 1.9 cm
* Ki-67: 1%
* No mitoses identified
* Negative surgical margins
* No lymphovascular invasion identified
* Perineural invasion present
* Extension into periappendiceal adipose tissue (mesoappendix) measuring 1.55 mm

So far, there is no evidence of metastatic or distant disease.

I was evaluated at a major neuroendocrine tumor referral center. Their recommendation was to undergo a completion right hemicolectomy, mainly for staging purposes and to rule out the possibility of microscopic lymph node involvement.

What makes this decision difficult is that, after the pathology review, several of the factors that initially concerned me were no longer present, particularly the lymphovascular invasion. However, the tumor size of 1.9 cm and the presence of perineural invasion remain.

I have been reading extensively about appendiceal NETs and understand that the overall prognosis for G1 appendiceal NETs is generally excellent. Because of that, I am trying to better understand the experiences of others who had tumors between 1 and 2 cm and had to decide between a completion right hemicolectomy and surveillance.

I would especially appreciate hearing from anyone who:

* Chose surveillance after appendectomy alone;
* Underwent a completion right hemicolectomy and can share the lymph node results;
* Had their treatment recommendation change after a pathology review;
* Has been followed for several years after an appendiceal NET diagnosis.

Thank you very much for sharing your experiences. Any insights would be greatly appreciated.