A9. General principles of oncological surgery

Last updated on September 10, 2021 at 17:55

Introduction

Surgery is a major modality in cancer, as it can be used for multiple purposes:

  • Surgical resection of the entire tumour with curative intent
  • Debulking (removing as much as possible of) a tumour with curative or palliative intent
  • Easing symptoms caused by the cancer with palliative intent
  • Diagnosing cancer by allowing for histology
  • Staging cancers
  • Prevention, in cases where the risk of cancer is unacceptably high (precancerous polyps, family history of breast or ovarian cancer, BRCA mutation)

Surgery is mostly used for N0M0 tumours, i.e. patients without nodal or metastatic disease. In some cases, surgery of metastases may be performed, like in liver or lung metastases from colorectal cancer. See also topic B44.

Cancers which are managed surgically

  • NSCLC
  • Breast cancer
  • Colorectal cancer
  • Oesophageal cancer
  • Gastric cancer
  • Skin cancer
  • Ovarian cancer
  • CNS tumours

Palliative surgery

Palliative surgery is important in cancer management. It is performed in incurable cases when the cancer is giving the patient symptoms which can be treated by surgery. Typical indications include pain, bowel obstruction, bleeding, and dysphagia. Resection or bypass may be used to relieve biliary or gastrointestinal obstruction. Gastrointestinal tumours and other tumours which compress other structures are the most frequent cancers requiring palliative surgery.


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