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Horizons in surgical oncology.

Future horizons in surgical oncology relate to advances in prevention, diagnosis, and treatment of the patient with cancer. New diagnostic modalities may make complete surgical staging unnecessary. Perioperative support of patients given multimodality treatment will become more critical as the limits of surgical resection are reached and combined treatment with radiation and chemotherapy become more frequent. The current treatment of cancer at several organ sites reflects the evolving approach to treat both local and systemic manifestations of the malignancy. Use of intraoperative radiation therapy with electron-beam and/or brachytherapy has been proved safe and future prospective trials will determine efficacy in local control of disease. Finally, proper reconstruction becomes critical as we attempt to rehabilitate cancer patients toward normal function.