Pre-operative identification of those patients with resectable disease, again, is of paramount importance. Whenever possible, local resection of the primary tumor remains the first order of business. In a study by Lai, et al. Vitola et al. With CT scanning ,the threshhold of sensitivity for lesions in the abdomen is approximately 2 cm, the threshold in the chest is 1 cm.
PET imaging appears to offer better sensitivity.
Results to date point to PET scanning as a way to avoid potential morbidity by performing a second operation for staging those patients with recurrent or suspected recurrent colorectal cancer. Hepatic resection increases the morbidity of the surgical management of colorectal disease. If more distant metastases are identified by PET, then hepatic resection of metastatic lesions may be avoided. Earlier and more accurate diagnostic techniques are needed to improve the detection and management of pancreatic tumors. By the time symptoms manifest and CT scanning is positive, resection is usually not possible.