Because in patients with appendix perforation all recurrences occurred within 2 years after index surgery we suggest more intense surveillance especially during the first 2 years, including physical examination, measurement of serum CEA and CA-19-9 tumor markers and CT scan or MRI at 1, 3, 6, 12 and 18 months, and every 6 months thereafter for at least 5 years. This evidence concerns the gene CEACAM5 and neoplasm.