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INTRODUCTION: A part of the literature supports the undoubtful advantage of neoadjuvant chemotherapy on the overall
survival and for the possibility of surgical conservative treatment in locally advanced tumours after downstaging. Other
authors report that primitive tumour’s surgical removal at first, improves survival in cases with locally advanced /metastatic
disease. The advantages were improvement of patient’s health status, removal of a reservoir of neoplastic cell neoangiogenic
cytokines and growth factors,and cytoreduction.
MATERIALS AND METHODS: Aim of this study is to evaluate the effectiveness on the survival of a primary surgical treatment
of the locally advanced tumours comparing two homogeneous groups. In the first group (GROUP 1) 40 patients
were enrolled with stage III A, III B,IV tumours and were treated with primary surgery. The second group (GROUP
2) was made up of 40 patients with similar stage treated with neoadjuvant chemotherapy. The surgical treatment had
the intention to remove the entire primary tumour.
RESULTS: After a median follow up of 48,2 months,22,5 % of GROUP 1 died and 30 % of GROUP 2. The average
survival of patients in GROUP 1 was 27,1 months while in GROUP 2 there was an average survival of 16,8
CONCLUSION: In conclusion surgical treatment plays a key role in the treatment of advanced/metastatic disease and is
an independent factor associated with survival.