Spread is primarily to the right colon, over the peritoneal surface and to ovaries
33% present at stage IV
If no carcinoma component is present, the prognosis appears to be very good, even with distant spread or positive nodes (96% overall disease specific survival)
Right hemicolectomy recommended, especially for the following:
Tumor recognized intraoperatively
Appendiceal margin positive
Involvement beyond muscularis propria
Perforation
Presence of carcinoma component (see carcinoma ex-goblet cell carcinoid LINK)
It has been suggested that tumors confined to the appendiceal wall with a clear surgical margin can be treated by appendectomy alone
