Читать книгу Surgical Management of Advanced Pelvic Cancer - Группа авторов - Страница 44

1 Disease progression: Delay to definitive surgery may allow local disease progression, resulting in more technically challenging resection and increased perioperative morbidity, or even unresectability. However, progression on full‐dose chemotherapy indicates an unfavorable disease profile that suggests disease course and outcome would not be altered by surgery.

2 Negative effect on performance status: Full‐dose systemic chemotherapy may negatively impact fitness, thereby delaying or preventing surgery. Reduced physiological reserve due to treatment‐related toxicity could increase the risk of perioperative morbidity (or even mortality). In practice this should not be the case with reasonable assessment of performance status, comprehensive geriatric assessment, adequate organ function parameters, and general well‐being [18]. It is better to wait for full recovery than to compromise outcome for timing.