Indications and General Oncologic Principles

  • Frederick L. Greene


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.


Laparoscopic Cholecystectomy Laparoscopic Resection Diagnostic Laparoscopy AJCC Cancer Stage Manual Laparoscopic Colorectal Procedure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Moynihan B. The ritual of a surgical operation. Br J Surg 1920; 8: 27.CrossRefGoogle Scholar
  2. 2.
    American Joint Committee on Cancer. AJCC Cancer Staging Manual. Philadelphia: Lippincott-Raven, 1997.Google Scholar
  3. 3.
    Greene FL. Laparoscopy in malignant disease. Surg Clin North Am 1992; 72: 1125–1137.PubMedGoogle Scholar
  4. 4.
    John TG, Greig JD, Crosbie JL, Miles WF, Garden OJ. Superior staging of liver tumors with laparoscopy and laparoscopic ultrasound. Ann Surg 1994; 220: 711–719.PubMedCrossRefGoogle Scholar
  5. 5.
    Conlon KC, Dougherty E, Klimstra DS, Coit DG, Turnbull ADM, Brennan MF. The value of minimal access surgery in the staging of patients with potentially resectable peripancreatic malignancy. Ann Surg 1996; 223: 134–140.PubMedCrossRefGoogle Scholar
  6. 6.
    Krasna MJ, Flowers JL, Attar S, McLaughlin J. Combined thoracoscopic/laparoscopic staging of esophageal cancer. J Thorac Cardiovasc Surg 1996; 111: 800–807.PubMedCrossRefGoogle Scholar
  7. 7.
    Conlon KC, Karpeh MS Jr. Laparoscopy and laparoscopic ultrasound in the staging of gastric cancer. Semin Oncol 1996; 23: 347–351.PubMedGoogle Scholar
  8. 8.
    Burke EC, Karpeh MS, Conlon KC, Brennan MF. Laparoscopy in the management of gastric adenocarcinoma. Ann Surg 1997; 225: 262–267.PubMedCrossRefGoogle Scholar
  9. 9.
    Warshaw A. Implications of peritoneal cytology for staging of early pancreatic cancer. Am J Surg 1990; 161: 26 - 30.CrossRefGoogle Scholar
  10. 10.
    Ribeiro U Jr, Gama-Rodrigues JJ, Safatle-Ribeiro AV, et al. Prognostic significance of intraperitoneal free cancer cells obtained by laparoscopic peritoneal lavage in patients with gastric cancer. J Gastrointest Surg 1998; 2: 244–249.PubMedCrossRefGoogle Scholar
  11. 11.
    Busch OR, Hop WC, Hoynck van Papendrecht MA, Marquet RL, Jeekel J. Blood transfusions and prognosis in colorectal cancer. N Engl J Med 1993; 13: 1372–1376.CrossRefGoogle Scholar
  12. 12.
    Vukasin P, Ortega AE, Greene FL, et al. Wound recurrence following laparoscopic colon cancer resection. Results of the American Society of Colon and Rectal Surgeons Laparoscopic Registry. Dis Colon Rectum 1996; 39: S20–S23.PubMedCrossRefGoogle Scholar
  13. 13.
    Beebe DS, McNevin MP, Crain JM, et al. Evidence of venous stasis after abdominal insufflation for laparoscopic cholecystectomy. Surg Gynecol Obstet 1993; 176: 443–447.PubMedGoogle Scholar
  14. 14.
    Caprini JA, Arcelus JI, Laubach M, et al. Postoperative hypercoagulability and deep-vein thrombosis after laparoscopic cholecystectomy. Surg Endosc 1995; 9: 304–309.PubMedGoogle Scholar
  15. 15.
    Jacobs M, Verdeja JC, Goldstein DS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1991; 1: 144 - 150.PubMedGoogle Scholar
  16. 16.
    Phillips EH, Franklin ME, Carroll BJ. Laparoscopie colectomy. Ann Surg 1992; 216: 703–707.PubMedCrossRefGoogle Scholar
  17. 17.
    Franklin ME, Rosenthal D, Norem RF. Prospective evaluation of laparoscopic colon resection versus open colon resection for adenocarcinoma. Surg Endosc 1995; 9: 811–816.PubMedGoogle Scholar
  18. 18.
    Lacy AM, Garcia-Valdecasas JC, Pique JM, et al. Short-term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancer. Surg Endosc 1995; 9: 1101–1105.PubMedGoogle Scholar
  19. 19.
    Bohm B, Milsom JW, Kitago K, Brand M, Stolfi VM, Fazio VW. Use of laparoscopic techniques in oncologic right colectomy in a canine model. Ann Surg Oncol 1995; 2: 6–13.PubMedCrossRefGoogle Scholar
  20. 20.
    Bohm B, Milsom JW, Kitago K, Brand M, Fazio VW. Laparoscopic oncologic total abdominal co lectomy with intraperitoneal stapled anastomosis in a canine model. J Laparoendosc Surg 1994;4: 23–30.Google Scholar
  21. 21.
    Milsom JW, Bohm B, Decanini C, Fazio VW. Lap aroscopic oncologic proctosigmoidectomy with low colorectal anastomosis in a cadaver model. Surg Endosc 1994; 8: 1117–1123.PubMedCrossRefGoogle Scholar
  22. 22.
    Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiger E, Elson P. A prospective, randomized trial comparing laparoscopic versus conven tional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 1998; 187: 46–54.PubMedCrossRefGoogle Scholar
  23. 23.
    Franklin ME, Rosenthal D, Abrego-Medina D, et al. Prospective comparison of open vs. laparo-scopic colon surgery for carcinoma. Five year results. Dis Colon Rectum 1996; 39: S35–S46.PubMedCrossRefGoogle Scholar
  24. 24.
    Lacy AM, Delgado S, Garcia-Valdecasas JC, et al. Port site metastases and recurrence after laparoscopic colectomy. Surg Endosc 1998; 12: 1039–1042.PubMedCrossRefGoogle Scholar
  25. 25.
    Fleshman JW, Nelson H, Peters WR, et al. Early results of laparoscopic surgery for colorectal cancer: retrospective analysis of 372 patients treated by Clinical Outcomes of Surgical Therapy (COST) Study Group. Dis Colon Rectum 1996; 39 (suppl): S53–S58.PubMedCrossRefGoogle Scholar
  26. 26.
    Stocchi L, Nelson H. Laparoscopic colectomy for colon cancer: trial update. J Surg Oncol 1998; 68: 255–267.PubMedCrossRefGoogle Scholar
  27. 27.
    Cuschieri A. Laparoscopic surgery of the pancreas. J R Coll Surg Edinb. 1994; 39: 178–184.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Frederick L. Greene

There are no affiliations available

Personalised recommendations