One of the major limitations many face here is that great snipe hunt for mets, or other hopefully "benign" processes, that generate biomarker elevations. With today's imaging technology, recurrent mets often are not identified on scans until after they are inoperable. Improved molecular imaging is an area of great opportunity to expand curative surgery.
Tomorrow there is a molecular imaging convention in San Diego, CA. Some might want to peruse the abstracts, looking for emerging techniques that might help us find mets months, or years, sooner than they can right now. If you can't see it, it is a lot harder to hit.