Appendix cancer secondary prevention: Difference between revisions
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*Cartcinoid tumors of appendix: | *Cartcinoid tumors of appendix: | ||
:*National Comprehensive Cancer Network (NCCN) and North American Neuroendocrine Tumor Society (NANETS) recommendations are base on the tumor '''size''' | :*National Comprehensive Cancer Network (NCCN) and North American Neuroendocrine Tumor Society (NANETS) recommendations are base on the tumor '''size'''<ref name="pmid20664473">Boudreaux JP, Klimstra DS, Hassan MM, Woltering EA, Jensen RT, Goldsmith SJ et al. (2010) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=20664473 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. [http://dx.doi.org/10.1097/MPA.0b013e3181ebb2a5 DOI:10.1097/MPA.0b013e3181ebb2a5] PMID: [https://pubmed.gov/20664473 20664473]</ref> | ||
::*Less than 2 cm : No follow up | ::*Less than 2 cm : No follow up | ||
:::* NANETS | :::* NANETS devided tumors < 2 cm into two categories: | ||
::::* Tumors less than 1 cm needs no further follow up | ::::* Tumors less than 1 cm needs no further follow up | ||
::::* Tumors between 1 and 2 cm with nodal metastasis, vascular invasion, lymphatic metastasis, mesoappendical invasion, intermediate and high grade as well as mixed histology): the same as tumors larger than 2 cm<math>\blacktriangledown</math> | ::::* Tumors between 1 and 2 cm with nodal metastasis, vascular invasion, lymphatic metastasis, mesoappendical invasion, intermediate and high grade as well as mixed histology): the same as tumors larger than 2 cm<math>\blacktriangledown</math> | ||
::*2 cm and more: History an d 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 (5HIAA and Chromogranin), imaging as clinically indicated. | ::*2 cm and more: History an d 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 (5HIAA and Chromogranin), imaging as clinically indicated. | ||
::* Followup Imaging studies: 6 moth after surgery, every 6-12 months for at least 7 years | ::* Followup Imaging studies: 6 moth after surgery, every 6-12 months for at least 7 years. | ||
Revision as of 21:12, 29 January 2019
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Appendix cancer Microchapters |
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Diagnosis |
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Treatment |
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Appendix cancer secondary prevention On the Web |
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American Roentgen Ray Society Images of Appendix cancer secondary prevention |
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Risk calculators and risk factors for Appendix cancer secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
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.
Secondary Prevention
Effective measures for the secondary prevention of appendix cancer include:
- Cartcinoid tumors of appendix:
- National Comprehensive Cancer Network (NCCN) and North American Neuroendocrine Tumor Society (NANETS) recommendations are base on the tumor size[1]
- Less than 2 cm : No follow up
- NANETS devided tumors < 2 cm into two categories:
- Tumors less than 1 cm needs no further follow up
- Tumors between 1 and 2 cm with nodal metastasis, vascular invasion, lymphatic metastasis, mesoappendical invasion, intermediate and high grade as well as mixed histology): the same as tumors larger than 2 cm<math>\blacktriangledown</math>
- 2 cm and more: History an d 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 (5HIAA and Chromogranin), imaging as clinically indicated.
- Followup Imaging studies: 6 moth after surgery, every 6-12 months for at least 7 years.
- Metastatic disease palliative managements:
- Liver resection for selected patients
- Embolization of the hepatic artery
- Somatostatin analogs did not show to reduce the tumor size, but they are helpful in symptom control
- Adenocarcinoma
- CEA, CA 125, CA 19-9 every 6 month for the first two years, then yearly for at least 3 more years, plus continued follow up in selected cases.
- Followup Imaging studies: 6 moth after surgery, every 6-12 months for at least 7 years
References
- ↑ 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