Erschienen in:
01.11.2005 | Editorial
Decreasing the Risk of a Treatment Expands Its Indications
verfasst von:
Paul H. Sugarbaker, MD, FACS, FRCS
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 11/2005
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Excerpt
A recent survey by the American Cancer Society of 957 adults revealed that more than half believed that surgery can cause cancer spread.
1 From my personal experience of 30 years of reoperative surgery in patients with gastrointestinal cancer, I am convinced that surgical procedures often disseminate cancer within the abdomen and pelvis. I agree with most Americans that a major problem exists. It is completely possible that patients with a gastrointestinal cancer come to the operating room with a contained process, but, unfortunately, as a result of surgical trauma, they leave the operating theater with cancer spread to the operative site and to the surrounding peritoneal surfaces. Often, the large primary cancer that is the focus of the operative procedure is successfully removed; it is the cancer cells the surgeon does not see that result in the abdominal and pelvic (local-regional) recurrence in a substantial proportion of patients. In colorectal cancer, this surgically induced cancer spread may occur in approximately 10% of patients, 30% of rectal cancer patients, 40% of gastric cancer patients, and 50% of pancreas cancer patients. As might be expected, the narrower the margins of resection and the greater the extent of lymph node positivity, the more likely that iatrogenic cancer dissemination will occur.
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