Lower GI 2017

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