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The Royal Marsden
Take home messages:
•
Primary tumour assessment of T substage and EMVI on imaging is a strong
predictor for synchronous metastatic disease
•
Liver only is dominant site of spread and MRI should be undertaken at
baseline to assess resectability
•
Pulmonary nodules should fulfil criteria for malignancy – irregular, >5mm
and multiple (otherwise routine follow up)
•
PET-CT is indicated for patients with metastatic disease diagnosed on
CT/MRI or unexplained rising CEA
•
Caution when PET-CT identifies extrahepatic metastatic disease – as
outcome data suggests this may not be prognostic, when conventional
imaging is negative