Indications and General Oncologic Principles
The management of cancer is a primary focus not only for the general surgeon but also for surgeons in many specialty areas. Despite the significant improvements in multimodality treatment over the last several decades, the extirpation of solid tumors continues to be the primary method of treating patients with cancer. Currently, neoadjuvant applications of chemotherapy and radiation are used to shrink tumor size or to “sterilize” the systemic circulation before removal of bulk tumors. The improvement in the cancer patient is still dependent on the ability to remove solid cancers, because the consequence of leaving residual tumor in place is incurability. The primary indication for any diagnostic modality is to obtain information that may provide pathologic certainty and data relating to the stage of the cancer. The current edition of the tumor, node, metastasis (TNM) staging manual2 developed by the American Joint Committee on Cancer provides staging strategies that relate to most solid tumors. Although laparoscopy is not considered a primary modality of staging for most abdominal tumors, endoscopic staging is built on the sound principles gained during the era when exploratory laparotomy was the diagnostic and staging mainstay for the surgeon.
KeywordsLaparoscopic Cholecystectomy Laparoscopic Resection Diagnostic Laparoscopy AJCC Cancer Stage Manual Laparoscopic Colorectal Procedure
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