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General principles of surgical oncology

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Presentation on theme: "General principles of surgical oncology"— Presentation transcript:

1 General principles of surgical oncology
Kwok-Leung Cheung

2 No conflicts of interest in the past two years to disclose.
Disclosure No conflicts of interest in the past two years to disclose.

3

4

5 Outline Surgery in context Principles of surgery
Challenges in geriatric oncology

6 Outline Surgery in context Principles of surgery
Challenges in geriatric oncology

7 Therapeutic options for solid malignancies*
Surgery Radiotherapy Systemic therapies – chemotherapy, endocrine therapy, targeted therapy, immunotherapy *cf Haematological malignancies

8 Therapeutic options for solid malignancies*
Tumour – operability, biology and sensitivity to therapy Patient – fitness, tolerability, choice Logistics Combinations and alternatives *cf Haematological malignancies

9 Outline Surgery in context Principles of surgery
Challenges in geriatric oncology

10 Surgery in Oncology Mostly therapeutic cf diagnostic
‘Removal’ of tumour – curative versus palliative Obtaining information (operative and pathological staging) Reconstructive surgery cf organ transplant Prophylactic surgery

11 Breast Surgery as a Model

12 Breast Surgery as a Model

13 Breast Surgery as a Model

14 Breast Surgery as a Model

15 Breast Surgery as a Model

16 Breast Surgery as a Model

17 Breast Surgery as a Model

18 Breast Surgery as a Model

19 Outline Surgery in context Principles of surgery
Challenges in geriatric oncology

20 Evidence Base Mainly retrospective cohorts
RCTs and GA-related studies emerging Not much on health economics Alternatives to radical surgery

21 better ones when to operate, and the best when not to operate.’
‘Good surgeons know how to operate, better ones when to operate, and the best when not to operate.’

22 Alternatives to Radical Surgery
No surgery or no treatment Non-operative treatment Minimally invasive surgery

23 Minimally Invasive Surgery

24 Minimally Invasive Surgery

25 Minimally Invasive Surgery

26 Selection

27 Factors contributing to postoperative complications
Age Co-morbidities Preoperative cognitive function Intensity of surgery

28 Optimisation

29 Outline Surgery in context Principles of surgery
Challenges in geriatric oncology

30 Basics of Surgery in Geriatric Oncology
Part of a multi-modality approach Achieving cure, palliation, staging, functional preservation and prevention Ongoing challenges in obtaining a strong evidence base, selection and optimisation of patients as appropriate

31 by surgery: it will be something we will inject.’
‘’We shall never overcome cancer by surgery: it will be something we will inject.’


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