Lower GI 2016

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