"Radical" abdominal cancer surgery: current state and future course.

Biologically driven cancer surgery is essential for the best care of the cancer patient. Modern technology and support have improved the safety and operative results of radical surgery. Better understanding of tumor biology with technical advances permit rational, en bloc resection of the primary cancer and regional lymphatic drainage with better cure rates. The author has operated on 1103 patients with liver tumors since 1970. The liver tumors were resected in 415 patients, with major hepatic resections being done in 359. Since 1979, the author carried out 62 regional pancreatectomies. Thirty-three were for stage 1 or 2 adenocarcinomas of the head of the pancreas. The 5-year actual survival was 31 per cent. There has been similar improvement in treating ampullary and periampullary cancer, gallbladder cancer, or extrahepatic bile duct cancer. These data show significant improvement in the results of treating cancer by radical or biologically driven surgery. Abdominal cancer is not a generalized disease until late in its course.