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This could be useful in planning more conservative surgery in selected cases.
However, with large masses, preoperative chemotherapy has been shown to reduce mass size allowing more conservative surgery[ 40 ].
In large but operable tumours, primary chemotherapy has also shown high response rates, allowing more conservative surgery.
The proposed benefits include tumour downstaging, which allows for more conservative surgery or more optimal cytoreductive surgery for unresectable tumours.
Neoadjuvant chemotherapy makes more conservative surgery feasible and, for patients with poor performance status, decreases the risk of postoperative complications.
For example, exposure to these tools resulted in patients choosing more conservative surgery options and reduced prostate specific antigen (PSA) screening [ 11].
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Neoadjuvant chemotherapy has been shown to correlate with improved disease free survival and overall survival in STS patients [ 6, 7], and preoperative radiation has been shown to reduce tumor burden before resection, allowing more conservative or function-sparing surgeries [ 8].
In reality, women who opted for CPM did not live longer than women who decided to treat their cancers with more conservative breast-conserving surgery and radiation treatment.
More recently, however, the focus of clinical interest has shifted to the third-generation nonsteroidal aromatase inhibitors (AIs) [ 10] such as letrozole and anastrozole as these drugs appear to produce at least comparable (anastrozole) or better overall response rates and permit more conservative subsequent surgery than tamoxifen [ 11- 14].
Adolescent surgery has more conservative guidelines than adult surgery.
In addition, it can enable patients to undergo more conservative sphincter-sparing surgery and there is a lower rate of acute side effects (Sauer et al, 2004).
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