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Dr Harsh Shah - GI & HPB OncoSurgeon
Dr Harsh Shah - GI & HPB OncoSurgeon

When and How Often to Check for Return of Appendix Cancer

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Recurrence Incidence and Optimal Surveillance After Complete Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Mucinous. DOI 10.1245s10434-025-18203-x

Appendix cancer is rare. When it spreads in the belly, doctors often treat it with surgery and heated chemotherapy, called CRS/HIPEC. This treatment can remove all visible cancer. But there’s still a chance it could come back. So how often should patients be checked after treatment?

This study looked at 385 people with mucinous appendix cancer. These patients had surgery and CRS/HIPEC, then were followed for many years. Doctors found that the chance of the cancer coming back changes over time.

In the first year after treatment, the cancer was most likely to return. The risk was highest for people with a more aggressive type of cancer called signet-ring cell. Patients with low-grade cancer had a much lower risk.

After the first year, the risk started to drop. By four years after treatment, the chance of the cancer returning was very low—especially for people with less aggressive cancers.

Based on these patterns, the study suggests a new schedule for follow-up visits. People with low-grade cancer may only need check-ups every 5 to 8 months in the first few years, then less often. People with more aggressive types should have more frequent visits at first—every 2 to 4 months—and then every 2 years later on.

This personalized plan means fewer hospital visits for those at low risk and closer care for those who need it most. Talk to your care team about what follow-up plan is best for you.

DOI: 10.1245/s10434-025-18203-x

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