Adjuvant chemotherapy in cancer surgery

Isolated surgical approaches to tumor treatment have largely reached a point beyond which prospects appear to be unpromising. The search for more promising therapeutic approaches, therefore, has become a compelling challenge. Surgico-adjuvant tumour chemotherapy has been more thoroughly studied than anything else in that direction. The underlying theoretical concept seems to be persuasive, though clinical results have so far stayed below expectations. Secured prolongation of life, following this therapy, has so far proved to be probable only for cases of osteosarcoma, mammary carcinoma with high risk of recurrence, testicular tumours, and neurogenic tumours. Neo-adjuvant chemotherapy seems to work well in cases of ENT tumours. Model studies into Lewis-Lung carcinoma have shown that therapeutic effects cannot be guaranteed unless a sensitised tumour is treated with an effective preparation. This is likely to add to the long-range importance of the individual aspects relating to surgico-adjuvant tumour chemotherapy. Methods have been and continue to be developed for that purpose. Yet, all of them need to be methodologically improved. At present, waiting for such improvement, surgico-adjuvant tumour chemotherapy should be used only within the framework of controlled clinical studies.