Imaging

PET to detect recurrence of colon cancer with serially rising CEA levels – pro

PET is being more frequenlty used to detect and identify recurrence. More recently NCCN has been more supportive of PET in this setting. It used to support PET only in the situation of rising CEA and no identified recurrence for localization of disease recurrence in patients with rising CEA level and non-diagnostic imaging studies, such as CT scans.However,  PET scan can potentially identify occult disease in this setting that CT misses. Therefore, 

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Posttreatment surveillance after hepatic metastases resection for colorectal cancer – pro

There are few guidelines on how to follow metastatic colon cancer patients with no evidence of disease because it is fairly new situation, with wider use of metasatectomy and after new effective drugs came on the scene and there are no mature studies. For high risk non-metastatic colon cancer,  NCCN guidelines for high risk colon cancers recommend annual CT of chest, abdomen and pelvis. Post-surgery surveillance is also warranted following resection

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