Basic principles of surgical resection of tumours Flashcards
What are the roles of oncological surgery?
Prophylactic surgery
Diagnosis and staging
Definitive excision
Palliative surgery
Cytoreduction
Management of oncological emergencies
Surgery for supportive therapy
Treatment of metastatic disease
Give an example of a prophylactic oncological surgery
Ovariectomy - reduces risk of mammary neoplasia
What methods of cytology can be performed to diagnose a tumour?
FNA
Impression smear
(doesn’t allow grading)
What methods of histology can be performed to diagnose and grade a tumour?
Core biopsy
Punch biopsy
Incisional biopsy
Excisional biopsy
How can the stage of a tumour be assessed?
Diagnostic imaging to determine if metastatic disease is present (spread of cancer)
What are the different levels of surgical dose?
Debulking/intralesional/cytoreduction
Marginal resection
Wide resection
Radical resection
Label the tumour
P = pseudocapsule
R = reactive zone
T = tumour
sk = skip metastases
st = satellite metastases
Describing cytoreductive excision of a tumour
leaves macroscopic volumes of tumour. Will recur unless given adjuvant therapy
describe marginal excision of a tumour
excision immediately outside the pseudocapsule of the tumour, leaving behind microscopic volumes of tumour. Local recurrence likely without adjuvant therapy
describe wide excision of a tumour
removal of the tumour with complete margins of normal tissue in all directions.
(local recurrence unlikely)
What are the most effective natural barriers to the spread of cancer?
collagen-rich relatively avascular tissues, including fascia, ligaments, tendons and cartilage
describe radical excision of a tumour
removal of an entire anatomical structure or compartment containing the tumour; e.g., limb amputation for a primary bone tumour
Local recurrence unlikely
