Intermediate Risk

The goals of surgery for patients with intermediate-risk disease are to establish the diagnosis, to resect as much of the primary tumor as is safely possible, to accurately stage the disease through sampling of non-adherent lymph nodes and previously unsuspected metastatic sites, and to obtain an adequate amount of tissue for diagnostic studies. In the current COG intermediate-risk clinical trial, patients with unresectable intermediate-risk tumors are treated with chemotherapy (see the present chapter). Using COG guidelines, resection may be performed at diagnosis and/or after the fourth and eight cycles. Cooperative group data is pending, but in singleinstitution studies surgery alone has been an effective treatment of loco-regional disease with intermediate-risk characteristics (Cheung et al. 1997; Kushner et al. 1996a). Since adjuvant chemotherapy is recommended only for patients with unresectable tumors, it can be avoided if the tumor can be removed.

0 0

Post a comment