Are hemicolectomies justified for appendiceal neuroendocrine tumours smaller than 2 cm?

Neuroendocrine tumours (NETs) of the appendix are clinically unique. They are nearly always discovered incidentally during appendectomies performed for other reasons, such as appendicitis. Small NETs of the appendix are known to have an insignificant risk of distant metastases. A seminal analysis of 150 people with appendiceal NETs reported that none of the 127 patients with tumours smaller than 2 cm developed distant metastases, compared with seven of 23 patients with larger tumours.1 This finding led to a consensus that simple appendectomy was sufficient for tumours smaller than 2 cm, whereas completion right-sided hemicolectomy was appropriate for larger tumours.