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April 1961

Extended Operations for the Treatment of CancerPresent Status of Controversial Extended Radical Surgical Procedures

Author Affiliations

From the Department of Surgery, Albany Medical College of Union University.

Arch Surg. 1961;82(4):562-568. doi:10.1001/archsurg.1961.01300100076007

Extended radical operations have been developed in recent years for use under highly selected conditions in the treatment of cancer. They differ from classical cancer operations in that, in an attempt to better circumscribe the disease process, either contiguous viscera or other adjacent anatomical structures are removed along with the tumor and the structures removed by conventional surgical procedures. Tumors arising in a number of anatomical sites have been approached in this way; for example, in carcinoma of the breast, removal of a portion of the chest wall along with the internal mammary vessels and the lymph nodes related to them as described by Urban1 and the additional dissection of the supraclavicular and anterior mediastinal lymph nodes suggested by Wangensteen2 are both extensions of radical mastectomy. A partial list of other extended operations includes composite operations3,4 for intraoral cancers (radical jaw-neck resection), pelvic exenterations for cancer of

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