Helical computed tomography inaccuracy in the detection of pulmonary metastases: can it be improved?
Helical CT misses metastases in 46% to 47% of cases. Accuracy of preoperative CT scanning for detection of pulmonary metastases was not improved with the provision of clinical history to the reader, nor was it influenced by the interpreter's training. A combined approach to pulmonary metastasectomy including preoperative and postoperative CT as well as manual lung palpation is necessary to render the patient disease-free.
Development of dermatologic adverse events within 60 days of sorafenib initiation is associated with better survival. Therefore, this should not to be taken as a negative event and discourage treatment maintenance. Likewise, second line clinical trials should be designed and/or evaluated considering this information to avoid significant bias.