[Surgical choices and approaches in treating tumor metastases]

In oncology metastatization modifies the prognosis and the quality of life of patients. Otherwise metastases are apt to make the surgeon to modify in many cases his operative decisions, and moreover means and times of the demolitive surgical procedures for curative purpose. Namely the presence of metastases at the diagnosis is not necessarily the cause of a refusal for potentially curative operations, both for sincrone or methacrone metastases, because there are still possible, also if less frequently, the hopes of success, especially if they are localized in particular target organs. Actual knowledge about pathogenesis of metastases during surgical procedures, induces us to adopt particular caution in demolitive operations, to avoid the risk that surgery facilitate their insurgence or dissemination. Finally the clinically primitive metastases pose diagnostic problems minimally different from what was the current strategy previously. The study consider these various facets of the problem, on the basis of personal experience and of literature data, and proposes operative protocols that are actually generally accepted.