This current issue of InFo ONCOLOGY & HEMATOLOGY focuses on surgery for two important tumor entities: colorectal carcinoma and pancreatic carcinoma.
Both tumor types are of great importance, not only for surgeons, but for all colleagues working in oncology and in ambulatory and primary care.
In their article on colorectal carcinoma, colleagues from the Department of Surgery at St. Josef Hospital in Bochum shed light on the key points of radical surgical techniques for the primary tumor. Here, they first provide an overview of oncologic colon resections in terms of resection margins and the importance of mesocolon excision with the trunk vessels to ensure complete removal of the lymphatic drainage area. In addition, the specifics of rectal cancer surgery are comprehensively presented. Here, in particular, the concept of total mesorectal excision has revolutionized surgery in the past two decades and led to a dramatic improvement in the local recurrence rate.
Pancreatic cancer is still a tumor with an extremely poor prognosis, which is often due to the late diagnosis, which, because of the often unspecific symptoms, is only made at a very advanced or metastasized stage, where surgical therapy is no longer possible. If the diagnosis is made earlier, however, radical surgery is the most important pillar of therapy to make long-term survival possible – in combination with adjuvant chemotherapy.
In their contribution, the Bochum group here presents the standards of surgical procedure and also highlights the aspects of preoperative management in icterus as well as the current developments in histologic workup and prognostic parameters. Here, the importance of the proportion of lymph nodes affected by the tumor in large series from different centers has been demonstrated in recent years.
Is surgery still useful for advanced pancreatic cancer? This question is the subject of our article, which focuses on indications, surgical procedures, and outcomes in locally extensive findings. The problem of vascular infiltration by the tumor, which is often found in the portal vein or mesenteric vein, can nowadays be solved surgically in the vast majority of cases. Involvement of adjacent organs is also usually not a contraindication to surgical intervention. Surgery can now also make an important contribution to the treatment of isolated local recurrence.
Another important aspect in the treatment of pancreatic cancer is neoadjuvant therapy, which has an increasing importance and is currently being investigated in numerous studies. Exciting developments can be expected here in the future, especially with regard to the type of pretreatment (combined radiochemotherapy or chemotherapy alone). This aspect is also presented in the articles on pancreatic cancer.
With this in mind, the current issue of InFo ONKOLOGIE & HÄMATOLOGIE provides a comprehensive surgical overview of current developments in the treatment of two important tumor entities. I wish you an exciting and informative read.
