Surgical management of metastatic tumors
Article first published online: 12 OCT 2013
© 2013 Wiley Periodicals, Inc.
Journal of Surgical Oncology
Special Issue: SEMINARS IN SURGICAL ONCOLOGY: Role of Surgical Metastasectomy in Oncologic Practice
Volume 109, Issue 1, page 1, January 2014
How to Cite
Shaha, A. R. (2014), Surgical management of metastatic tumors. J. Surg. Oncol., 109: 1. doi: 10.1002/jso.23454
- Issue published online: 13 DEC 2013
- Article first published online: 12 OCT 2013
- Manuscript Received: 10 SEP 2013
- Manuscript Accepted: 10 SEP 2013
One of the greatest advantages of working in an academic center such as Memorial Sloan-Kettering Cancer Center is to have fantastic group of surgical fellows who are totally devoted to the care of the patient, education, research, and academic leadership. Amongst a variety of topics discussed during the surgical procedures, one of the subjects that came up recently was management of metastatic disease to various organ sites in the human body. Since we have several services in the department of surgery, it was quite appropriate to consider compiling an issue of JSO related to management of metastatic tumors. Brian Untch, our senior surgical oncology fellow took the lead and came up with the idea of requesting various fellows on different services along with the attending surgeon to write review manuscript on metastatic tumors to different organs. This was quite a successful endeavor.
The success of modern chemotherapy regimens and targeted therapies has made considerable improvements in survival from different types of cancer. The surgical resection for metastatic tumors continues to evolve with definitive treatment in selected patients where the disease is limited to one organ site. Selected patients with limited metastatic disease which occurs synchronously with the initial tumor may be considered candidates for surgical resection with the exception of colo-rectal cancer metastatic to the liver. The majority of the other types of metastatic tumors does not have extensive literature to develop guidelines or help make treatment decisions. Selectively identifying patients who may benefit from metastasectomy or resection of the recurrent disease can be a challenge to the oncologic surgeon. Important factors include disease free intervals, cancer type, extent of required resection, patient's general conditions and co-morbid conditions and predicted chemotherapy sensitivity.
In this issue of JSO, authors from Memorial Sloan-Kettering Cancer Center have reviewed topics of surgical resection in the setting of isolated metastasis or recurrence by organ site. The majority of the data published in this series is retrospective but nonetheless these reviews will hopefully serve as a starting point for future prospective studies both from surgical point of view and targeted therapies. As chemotherapy and molecular pathway inhibitor responses improve, this topic will only become more important as we identify patients who may benefit from most formal resection in the setting of metastatic or recurrent tumor. We do hope this issue of general surgical oncology will be helpful in future development of management of metastatic tumor which continues to be a difficult and challenging problem.