The easier the diagnosis the worse the prognosis. This statement hardly needs further comment or illustration. It is especially true in malignant disease. When the surgeon is able to recognize cancer by its clinical appearance the relative prognosis is bad. Complete operations in this stage yielded 30 per cent, or less of permanent cures.
When the malignant disease cannot be recognized clinically because of its early stage, but is diagnosed at the exploratory incision by its gross appearance, with or without the aid of a frozen section, the prognosis for an ultimate cure is best, provided the complete eradication of the disease immediately follows the exploratory diagnosis. My investigation of the statistics up to date seems to show that the probabilities of a cure are at least 80 per cent. This, of course, varies with the position of the lesion.
If at this exploratory incision, however, the malignancy is not
BLOODGOOD JC. THE ADDED RESPONSIBILITY OF THE SURGEON WHEN CALLED ON TO TREAT SURGICAL LESIONS IN THEIR EARLIER STAGES. JAMA. 1913;61(12):911–916. doi:10.1001/jama.1913.04350120001001
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