ABSTRACT
The cancer field theory sets up the new principles of radicality for surgical tumor treatment, namely the resection of the tumor-bearing compartment with intact borders and of the basin lymph nodes as well as the intercalated lymph nodes for which the cancer field is tributary. If the first-line lymph nodes, which are the nodes that are directly connected to the cancer field by afferent lymphatics, contain metastases, downstream second-line nodes have to be resected as well; otherwise the resection of the first-line nodes alone is therapeutic. Tissues outside the cancer field can safely be retained despite their close proximity to the tumor front. Cancer field resection and therapeutic lymph node dissection should result on the one hand in maximum locoregional tumor control without adjuvant radiation, and on the other hand in minimal treatment-related morbidity. Only at the site of intracompartmental resection, which may be indicated to preserve functional aspects, a metrically defined tumor-free resection margin has to be achieved.
