Would you consider a somatostatin analog for a patient with carcinoid involving ileum and appendix with positive mesenteric margin after right hemicolectomy and liver metastases that have been resected?

I generally would not unless there was a substantial amount of residual disease per se and/or there were symptoms of the carcinoid syndrome which is very unlikely after near total resection of metastases.

Patients with small bowel NETs (carcinoid tumors) and liver metastases are rarely, if ever, cured of their malignancy with resection of metastases as most will likely have small hepatic micrometastases scattered throughout the liver. Although some studies have shown that hepatic micrometastases are associated with worse prognosis, many patients can go on for years without therapy before metastases become apparent and there has never been a study confirming that any type of early intervention with a somatostatin analog (SSA) improves outcome...