Status of surgical trials in clinical oncology, part 2

Recent prospective randomised trials dealed with the optimal extent of surgical resection as well as with preoperative therapy modalities in pancreatic, rectal and breast cancer. In pancreatic cancer extended lymphadenectomy did not improve overall survival. Total mesorectal excision remarkably changed surgery for rectal cancer. Rate of local recurrence of rectal cancer could be significantly reduced by preoperative irradiation. In advanced rectal cancers curative resection and sphincter preservation seems possible due to multimodal preoperative therapy. It has been demonstrated that in appropriate cases breastpreserving resection is comparable to mastectomy with respect to overall survival. Up to now it is not quite clear if sentinel node sampling is equivalent to routine lymphadenectomy. Following neoadjuvant chemotherapy breastpreservation rate is significantly higher, but survival is not significantly increased.