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In Reply.—I would like to thank Dr Adar for his interest in our study. However, I would respectfully take issue with his contention that our conclusions are unsupported by our data. The quote used by Dr Adar from our abstract contains the word "potential" in relation to curability of lesions. This refers to a distinction between patients with stage III and IV disease, the latter of whom are not even potentially curable. However, even in the presence of positive regional nodes (stage III), a small but significant cure rate has been associated with resection. Certainly, no patient with stage III disease has been cured without resection. Thus, the misdiagnosis by CT scan as stage IV, when the correct stage is III, could potentially be to their disadvantage.
While Dr Adar insists on lumping all patients with stage III and IV disease together, our only claim for overdiagnosis by CT
LEVINE BA. Responsibility of Clinical Surgeons Who Write-Reply. Arch Surg. 1987;122(8):958-959. doi:10.1001/archsurg.1987.01400200108029