Surgical oncology

The main aim of oncological surgery is tumour ablation, i.e. to remove the tumour or cancerous tissue. The earlier the tumour is removed and the more localised it is (located in one place (primary tumour) without spreading to other parts of the body (metastasis)), the more effective the surgery will be. In this type of procedure, the surgeon will also remove a small piece of normal tissue around the tumour – known as the ‘surgical margin’ – to ensure that no cancer cells remain.

To minimise damage to healthy tissue while ensuring that all cancer cells are removed, the surgeon may perform a biopsy to find the sentinel ganglion (the first lymph node to which the cancer is likely to spread from its original location). If there are no cancer cells in the sentinel ganglion, there will be no need for lymph node dissection.

For some types of cancer, it may be necessary to remove the lymph nodes located near the tumour, which is referred to as lymph node dissection. These removed lymph nodes are then analysed to determine if they contain cancer cells, which could form new tumours or spread to other parts of the body.

In some cases, it is not possible to remove the entire tumour and so tumour reduction is performed (‘cytoreductive surgery’), which may increase the effectiveness of systemic therapy or adjuvant radiotherapy.

Palliative surgery or septic surgery can relieve symptoms and thus improve the patient’s quality of life (e.g. relieve pain, bypass a blocked organ, etc.). The main objective of this type of surgery is often to control symptoms (and thus improve quality of life) rather than to treat the disease.

In some cases, in addition to removing the tumour with a healthy tissue margin, the surgeon may also remove other structures (e.g. muscles, nerves, normal lymph nodes) in the vicinity of the tumour. This procedure (radical surgery), as demonstrated by various studies and research findings, reduces the risk of reappearance or recurrence (e.g. radical mastectomy: breast removal (whole), pectoral muscles and underarm lymph nodes).