General considerations

Surgery is the mainstay of treatment—and principal hope of cure— for most patients with solid tumours. Surgery is most effective when cancer is localized, and substantial numbers of long-term survivors can be achieved with some tumour types that show metastatic disease at presentation.

Surgery has an advantage over radiotherapy as long-term morbidity of treating tissues without the primary tumour is significantly less; this must be balanced against disruption of normal anatomy inherent in radical resection of cancer, with potential loss of cosmesis and function.

Surgery has three main roles in the management of cancer patients:

♦ Diagnosis and staging

♦ Palliative

Surgery is the longest-established treatment for cancer and remains the foremost curative treatment of choice for many localized cancers. It has a role to play in the treatment of both primary and secondary cancer as well as palliation.

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