[Surgery called tumoral reduction: myth or reality?]

The cytoreductive surgery (CS) or surgical debulking of tumors is supported by the following experimental concept: the maximal but incomplete resection of huge tumoral masses (debulking) induces the passage of remaining cancerous cells in proliferative cycle. So, these remaining cells become sensitive to chemotherapy, or eventually to radiotherapy. In this way, the CS appears to be a neoadjuvant treatment to the chemotherapy, this last treatment being the powerful therapeutic. In this study, we have studied successively: the theoretical basis of the CS, the experimental positive and negative arguments of this concept, and then the positive and negative clinical applications. At least, it seems that CS is more a myth than a reality, and that we should only keep the classical concepts of curative surgery or palliative surgery.