Oncology Surgery Flashcards
What is the role of surgery in Cancer treatment?
Obtaining a diagnosis via biopsy
Curative surgery/Long term tumor control
Palliation of clinical signs
Debulking surgery prior to adjunctive therapy
Prevention/reduction of risk recurrence
Ancillary procedures; vascular access port placement
How do you diagnose round cell tumor malignancies?
Cytology
What is useful for staging distant metastasis?
Radiography Ultrasound CT MRI Pet Scan Nuclear Scintigraphy
What is the Gold standard for Diagnosis of Neoplasia?
Biopsies
What are the types of biopsies?
Impression smears of ulcerated masses Needle core biopsies Endoscopic/Laparascopic Incisional Excisional
Incisional Biopsy
Removing a piece from the mass
Excisional Biopsy
Removing the entire visible mass
What are the indications for Incisional Biopsy?
Less invasive sampling
Location, size, or tumor type/grade could affect treatment planning
What are the disadvantages for incisional biopsy?
Will require second surgical procedure
May create communication between neoplastic and normal tissue (cell seeding)
What are the indications for excisional biopsy?
Removes tumor along with margin of surrounding normal tissue
Allows removal of smaller, non-invasive masses in single procedure
When should an excisional biopsy be considered?
Gingival lesions
Lesion is known to be benign
Lesion is small
Treatment would not be altered by tumor type
Re-excision possible without great morbidity
What are the principles of Surgical Oncology?
Minimize handling of tumor Ligate blood supply early as possible Excise biopsy tract Biopsy or excise draining LNs Lavage tissues, change gloves and instruments and lavage before closing Avoid use of drains if possible
What are the excisional classifications of tumors?
Intracapsular
Marginal/Cytoreductive
Wide
Radical
When would you perform a marginal/cytoreductive excision?
Lipomas
Benign masses
What tumors should have wide excision?
Mast cell tumors (high Grade)
Soft tissue sarcomas
