For a large number of cancers-but also in the minds of many patients —surgery is the first and most effective oncological treatment. The idea of mechanically removing the source of the disease and of cleansing the original location of all evil often seems like a fundamental gesture for patients; they will more readily feel abandoned, or seriously attacked, if an operation is not possible. It might be said that the ‘surgical attitude’ even corresponds to a way of thinking, since in a certain number of cases we continue to intervene in this way, even when we know that the disease is systemic. In saying that, I do not of course argue against clear indications for oncological surgery.