[Therapeutic modalities and prognosis].
The individual prognosis of a patient with gastrointestinal cancer is determined by a number of clinical and biological factors. The most relevant prognostic factors are those that can be influenced by the surgeon himself. The completeness of tumor resection, the so-called residual tumor status on the level of the primary tumor in all three dimensions and on the level of the lymphatic drainge is the outstanding factor with an independent influence on the survival of the patient. In addition, the principles of blood-saving preparation with avoidance of blood transfutions, the consideration of no-touch isolation and the complication-free postoperative course have been shown to be independent prognostic factors that can be influenced by the surgeon. There is clear evidence that the hospital volume and the experience of the surgeons, expressed by the number of cases (caseload) in a specific field, has a strong impact on the outcome of a surgical treatment in gastrointestinal cancer patients. To optimize the prognosis of a patient with gastrointestinal cancer one should consider all therapy-related prognostic factors, and therapeutic modalities should be scheduled after a consensus conference (tumor board) of all therapeutic fields involved in the treatment of cancer.
Schuhmacher
C
C
Chirurgische Klinik und Poliklinik, Technische Universität München.
Siewert
J R
JR
D002173:Cancer Care Facilities; D002983:Clinical Competence; D003131:Combined Modality Therapy; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D009367:Neoplasm Staging; D010348:Patient Care Team; D011379:Prognosis; D015996:Survival Rate