Developments in surgical oncology--past, present, and future trends

Area of Science:

• Oncology
• Cancer Treatment
• Multimodal Therapy

Background:

• Locally advanced or aggressive cancers often have unsatisfactory outcomes with surgery or radiotherapy alone.
• The historical development of integrated treatment strategies is crucial for improving patient prognosis.

Purpose of the Study:

• To review the historical development of integrated treatment programs for advanced cancers.
• To highlight the role of induction chemotherapy in multimodal cancer treatment.

Main Methods:

• Review of historical data and treatment protocols for integrated cancer therapy.
• Emphasis on the sequence of treatment modalities: induction chemotherapy followed by radiotherapy and/or surgery.

Main Results:

• Induction chemotherapy, particularly intra-arterial infusion, is effective when tumor vasculature is intact, offering a greater regional effect.
• Subsequent radiotherapy and/or surgery can eradicate central residual tumors.
• Regional induction chemotherapy shows promise in locally advanced stage III breast cancer, head and neck cancers, gastric cancer, and limb sarcomas/melanomas.

Conclusions:

• An integrated, team-based approach involving multiple specialists (surgical oncologists, medical oncologists, radiotherapists, immunologists) is essential for optimizing treatment results.
• Early application of induction chemotherapy, especially regional, is a key component of successful integrated cancer treatment programs.