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Surgical Oncology (Hardcover, 1997 ed.)
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Surgical Oncology (Hardcover, 1997 ed.)
Series: Cancer Treatment and Research, 90
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Among the standard oncology modalities, surgical oncology is
singular in that it lacks a separate board certification or even an
added qualification mecha nism. 'Card-carrying' surgical
oncologists are certified by the American Board of Surgery, as are
all other general surgeons. What distinguishes the surgical
oncologist is a set of cognitive skills rather than a specific
armamentarium of surgical techniques. This different conceptual
framework is derived from ex tensive additional training that leads
to an in-depth understanding of the natural history and biologic
behavior of the various solid tumor systems. Equipped with this
perspective, the surgical oncologist is particularly well
positioned to integrate the various available therapeutic
modalities into a coherent care program for the solid tumor
patient. As a central theme, the chapters of this book demonstrate
that increasingly sophisticated diagnostic and staging approaches
are helping to move chemo therapy and radiotherapy into the
preoperative neoadjuvant setting. This fundamental alteration is
based on the awareness that even early-stage solid tumor disease is
frequently systemic at the time of presentation, at least on a
subclinical level. And although the primary tumor may be
controllable by surgery with radiotherapy, the uncontrolled (and
initially clinically unappar ent) distant disease ultimately
determines patient survival. The other perspec tive driving the
neoadjuvant approach is an emerging awareness that for most solid
tumor systems, neoadjuvant treatment responses can facilitate less
muti lating surgery with comparable levels of local disease
control.
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