[Status of surgical studies in oncology. I]

Advances in surgery, anesthesiology and in critical care remarkably elevated safety of surgical therapy of cancer. However, prognosis of most cancer types as esophageal and gastric carcinoma--as discussed in this part of the survey--did not improve, even not after adjuvant therapy. To enhance curative resection rate chemotherapy and radiation or a combination of both have been performed preoperatively. The weakness of radiotherapy is control of distant metastases, chemotherapy failed in local tumor control. Multimodal preoperative strategies offered enhanced survival in responders, but overall there was no significant survival advantage. Until now neither in esophageal nor in gastric cancer randomised studies could demonstrate a substantial overall survival benefit after extended lymphadenectomy.