8. Surgical oncology (basic principles of treatment)

Question 1

En bloc resection

Answer 1

complete removal of the tumour itself and any organs that are involved in the cancer to get tumor free margins and thereby reduce the risk of local recurrence

Question 2

Removal of metastases depends on

Answer 2

•Disease free interval duration
•Organs of involvement
•Ability to leave the patient tumour free
without affecting the function of the
organs involved too much (hepatic metastasis from colorectal cancer is easy to remove)

Question 3

Primary chemotherapy

Answer 3

chemotherapy alone without radiation or surgery. Used

in haematological malignancies.

Question 4

Chemotherapy prior to surgery

Answer 4

permits a less radical operation, i.e used in breast cancer to preserve breast tissue

Question 5

Chemotherapy as an adjuvant to

surgery/radiation

Answer 5

Used in patients with high risk of relapse and in specific treatments

Question 6

Main non-surgical treatments

Answer 6

• Chemotherapy
• Radiotherapy
• Hormone therapy
• Immunotherapy
• Gene therapy

Question 7

Determination of treatment results factors

Answer 7

• Overall survival: from onset of therapy to death of patient
• Disease free survival time
• Effects of treatment:
  
  • Complete remission
  • Partial remission
  • Stabile disease
  • Progression

Question 8

Prognostic factors

Answer 8

• Patient-related factors (age, sex, condition etc)
• Tumour-related factors: TNM, histology, vessel invasion, grading
• Genetic factors: oncogenes, suppressor gene mutations (p52, BRCA,Her-2 etc)

Question 9

Follow-up routines

Answer 9

• Follow-up visits starting at 1-3 month intervals and eventually at 6 month intervals throughout life
• The aim is early detection of recurrent disease or progression
• Treatment of therapy-induced complications
• Early diagnosis of possible second tumour