Staged vs. Upfront Colectomy for Appendix Cancer: New Findings

Dr. Muhammad Talha Waheed, a postdoctoral research fellow at City of Hope, was recently interviewed by Cancer Network about study findings he first presented in a poster at the 2025 Society of Surgical Oncology (SSO) Annual Meeting. The research looks at the timing of surgery for appendix cancer and suggests a staged colectomy may be preferable in some cases.

What is a staged colectomy?

In a staged approach, a patient first has an appendectomy (removal of the appendix), followed later, if needed, by a right colectomy (also called a right hemicolectomy – removal of the right side of the colon). In an upfront approach, the right colectomy is performed as the first operation.

What the research found

• A staged colectomy was associated with the best survival in the analysis (hazard ratio 0.52).
• An upfront colectomy was associated with the worst survival (hazard ratio 2.13).
• An estimated 26–33% of tumors may turn out to be low-grade or benign and may need only an appendectomy.

A staged approach may therefore offer survival benefits and help some patients avoid a more extensive surgery they may not need.

Why it matters

Today, there are no national consensus guidelines on the best sequence of surgery for appendix cancer, so the decision is largely left to the surgeon. Dr. Waheed recommends that staged versus upfront colectomy be discussed at treatment consensus meetings and within the broader medical community to help guide the best surgical approach going forward.

Seeing a specialist experienced in appendix cancer can make a difference. Use ACPMP’s Find a Specialist map to locate one near you.

Learn more

Read Cancer Network’s interview with Dr. Waheed.

This summary is for general information only and is not medical advice. Please talk with your care team about what this research may mean for you.