Surgical debulking of tumors.

Surgical debulking of tumors is a procedure whereby a surgically incurable malignant neoplasm is partially removed without curative intent in order to make subsequent therapy with drugs, radiation or other adjunctive measures more effective and, thereby, improve the length of survival. Debulking has been advocated for carcinoma of the testis and ovary, a subtype of lymphoma, sarcoma, renal cell carcinoma, adrenal and other endocrine-related tumors, neoplasms of the central nervous system and other miscellaneous tumors. Nonrandomized data indicate that surgical debulking is rarely indicated; however, complete resection of all gross disease following intensive chemotherapy is indicated for advanced carcinoma of the testis. Complete or nearly complete resection of all gross disease prior to chemotherapy is indicated for advanced carcinoma of the ovary and possibly for Burkitt's lymphoma. Prospective randomized studies of all three of these malignant conditions would be appropriate, and an evaluation of preoperative intensive chemotherapy for advanced carcinoma of the ovary and Burkitt's lymphoma also may be warranted.