Follow-up of Neuroendocrine Tumours:
Low-risk Resected Disease
- All of the following: primary less than 2 cm, no nodal involvement, and low Ki67 index (<5%)
- Low risk of recurrence
- Routine surveillance imaging or lab work is not recommended. Clinical follow up at the discretion of the treating physician.
High-risk Resected Disease
- Surveillance per the table below if any of the following high risk features: primary greater than 2 cm, nodal involvement, high Ki67 (≥5%)
- If high risk and grade 3 disease – period of recommended follow-up is 5 years
- If high risk and grade 1-2 – period of recommended follow-up is 10 years
Test
|
Year 1
|
Years 2-10
|
5-HIAA (if functional)
| not recommended
| not recommended
|
Chromogranin A
| not recommended
| not recommended
|
CT scan
| annually
| annually
|
Nuclear Medicine imaging
| if any of the above are abnormal
| |
Post-debulking with no visible residual disease
Test
|
Year 1
|
Years 2-3
|
Year 4-5
|
5-HIAA (if functional)
| every 3–6 months
| every 6 months
| annually
|
Chromogranin A
| every 3–6 months
| every 6 months
| annually
|
CT scan
| annually
| annually
| annually
|
Octreotide or MIBG scan
| if any of the above are abnormal
| if any of the above are abnormal
| if any of the above are abnormal
|
Unresected disease (metastatic or residual-positive post-debulking)
Test
|
Year 1
|
Years 2-5
|
5-HIAA (if functional)
| every 3–6 months
| every 4–6 months
|
Chromogranin A
| every 3 months
| every 4–6 months
|
CT scan
| every 6 months
| every 6 months – 1 year per clinical discretion
|
Octreotide or MIBG scan
| if any of the above are abnormal
| if any of the above are abnormal
|
Echocardiogram
| annually if 5-HIAA is over 70 mg/24 hours
| annually if 5-HIAA is over 70 mg/24 hours
|