Appendix cancer secondary prevention
Appendix cancer Microchapters
Appendix cancer secondary prevention On the Web
American Roentgen Ray Society Images of Appendix cancer secondary prevention
There are neither evidence based guidelines nor RCTs for follow up of appendix carcinoid tumors. Meanwhile, consensus based effective measures for the secondary prevention of appendix cancer include follow up history and physical examination, tumor marker measurements like CEA, CA-125, CA 19-9, follow up imaging studies, carcinoid tumor markers such serotonin, and specific imaging studies such as octreotide scintigraphy.
Effective measures for the secondary prevention of appendix cancer include:
- Carcinoid tumors of appendix:
- Less than 2 cm: No follow up
- NANETS devided tumors < 2 cm into two categories:
- Two cm and more: History and physical examination between 3-12 months plus tumor markers as well as imaging studies consideration for the first year, then tumor markers every 6-12 months (5-HIAA and chromogranin-A), imaging as clinically indicated.
- Followup imaging studies: 6 month after surgery, every 6-12 month for at least 7 years.
- Metastatic disease palliative managements:
- Liver resection for selected patients
- There are no appropriate evidences in role of tumor markers for follow up of the patients with appendix adenocarcinoma, indeed current consensus is based on colorectal cancer experience.
- Boudreaux JP, Klimstra DS, Hassan MM, Woltering EA, Jensen RT, Goldsmith SJ et al. (2010) The NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: well-differentiated neuroendocrine tumors of the Jejunum, Ileum, Appendix, and Cecum. Pancreas 39 (6):753-66. DOI:10.1097/MPA.0b013e3181ebb2a5 PMID: 20664473