PHYSIOPATHOLOGIC BASIS AND ROLE OF THE SURGICAL ONCOLOGY IN THE FORMATION OF THE GENERAL SURGEON

Abstract

Surgical oncology can currently be definite «bio-surgery» in as more frequently uses in pre-, intra and postoperative phase biological substances what growth factors, cytokines, antiadhesion and neoangiogenesis inhibiting molecules with a potential reduction of the local recurrences and improvement of survival rates.

The increasing and continuous development of the genic therapy, cellular therapies, immunotherapy, chemotherapy and radiotherapy in the cancer treatment, «force» surgeon to interrogate himself on the role of the radical surgery through the «advanced» tumors of the digestive tract.

Surgery alone, continuous to be in terms of recovery, the most effective treatment against tumor, (62% of the recoveries), also if its combination with other therapies improve the results especially in the advanced tumors.

Chemotherapy has had positive results in the treatment of solid tumors, sometimes like adjuvant or neoadjuvant treatment to a radical surgery, improving the survival rates.

Surgical oncology of “tomorrow” must be necessarily a quality surgery performed from a surgeon possessing some necessary requisite: technical ability, specific base-formation on physiopathologic knowledge in constant evolution, standardization ability of surgical techniques and therapeutic protocols.

Such requisite will allow surgeon reach the main goal of surgical oncology what the local control of tumor, reduction of local recurrences, offer an good enough quality of life getting all the possible information on the local development of tumor and on the ways of diffusion.

All these elements will be necessary for formulate a reliable prognostic judgment, more and more requested from the patients.