The evolution of cancer surgery and future perspectives.
Surgery is the oldest oncological discipline, dating back thousands of years. Prior to the advent of anaesthesia and antisepsis 150 years ago, only the brave, desperate, or ill-advised patient underwent surgery because cure rates were low, and morbidity and mortality high. However, since then, cancer surgery has flourished, driven by relentless technical innovation and research. Historically, the mantra of the cancer surgeon was that increasingly radical surgery would enhance cure rates. The past 50 years have seen a paradigm shift, with the realization that multimodal therapy, technological advances, and minimally invasive techniques can reduce the need for, or the detrimental effects of, radical surgery. Preservation of form, function, and quality of life, without compromising survival, is the new mantra. Today's surgeons, no longer the uneducated technicians of history, are highly trained medical professionals and together with oncologists, radiologists, scientists, anaesthetists and nurses, have made cancer surgeries routine, safe, and highly effective. This article will review the major advances that have underpinned this evolution.
Department of Oncology, Royal Hallamshire Hospital, University of Sheffield, Glossop Road, Sheffield S10 2RX, UK.
Lynda
L
Wyld
Department of Surgery, St Helens Teaching Hospital, University of Liverpool, St Helens, Merseyside WA9 3DA, UK.
Riccardo A
RA
Audisio
Department of Surgery, Aintree University Hospital, Longmoor Lane, Liverpool, Merseyside L9 7AL, UK.
Graeme J
GJ
Poston
D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000601:surgery; D003131:Combined Modality Therapy / Q000639:trends; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000639:trends; D009369:Neoplasms / Q000175:diagnosis / Q000601:surgery*; D010348:Patient Care Team / Q000458:organization & administration; D013514:Surgical Procedures, Operative / Q000639:trends