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Two European level I randomized controlled trials refute Asian lesser level evidence promoting more radical resections.
Neoadjuvant treatment increased the radical resection rate; in patients who received radiotherapy (either full course or re-irradiation) or radiochemotherapy significantly more radical resections were performed than in patients who did not.
The high-definition exoscope system, modified to detect 5-ALA-induced fluorescence, is useful both for guided surgery of suspected high-grade gliomas and frameless MRI stereotactic biopsies, acting as a valuable tool to achieve more radical resections in brain tumor surgeries and decreasing the chances of negative biopsies.
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The hypogastric nerve is dissected free from the uterosacral ligaments and the surrounding tissue, permitting a far more radical resection of the entire uterosacral ligaments and rectal pillars (Fig. 2 right).
Whether they directly compare to local excision or more radical resection has not been proven.
Once definitive histopathology is obtained, a further, more radical resection may have to be considered.
The other strategy aims at improving the cure rate by performing a more radical resection.
The introduction of fluorescence-guided resection allows a better identification of tumor tissue and its more radical resection.
Transhiatal with mediastinal lymphadenectomy plus TG comprises a more radical resection margin that prevents residual disease at the esophageal margin and allows removal of all the perigastric and peridiaphragmatic hiatus lymph nodes.
However, Yoo et al had found that the recurrence rate of TG group was lower than PG group, because it might have been associated with more radical resection extent.
After re-irradiation significantly more radical resection could be performed (64.9 versus 29.2%, P = 0.004) and a significantly better metastasis-free survival (MFS) (at 3 years: 58.7 versus 17.8%, P < 0.001) was observed compared to surgery alone in patients who had been irradiated for their primary tumor.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com