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The Royal Marsden
Suggested algorithm for IPN
•
Pulmonary nodule and no previous imaging to compare:
High risk primary: compare against post op/postRx CT
• If enlarging refer for VATS/metastatectomy after 1st line metastatic
chemotherapy
• If no change but post op CEA elevated, check PET-CT, surveillance CT
after completion of adjuvant chemotherapy
Low risk/postop CEA normal: consider additional surveillance CT,
likelihood of malignancy is low
•
Consider possibility of synchronous lung primary in low risk
colorectal cancer