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INTRODUCTION

A little over 1.75 million individuals in the United States are expected to be diagnosed with invasive cancer in 2023, with more than 6,000,000 estimated cancer deaths. Currently, cancer is the second leading cause of death in the United States behind heart disease. Fortunately, over the past several years, cancer death rates have decreased. From 2001 to 2020, cancer death rates decreased 27%, from 196.5 to 144.1 deaths per 100,000. Reasons for this include population changes in cancer risk factors (eg, decreased rates of smoking), cancer vaccines to prevent viruses that can lead to cancer, cancer screening tests that can detect cancer earlier when treatment is more effective, and new cancer treatments, such as targeted therapies or immunotherapy.

The surgeon is intimately involved in the care of cancer patients because the majority will require surgical therapy at some time. Surgeons are often the first specialists to see newly diagnosed cancer patients or are often called upon to make the diagnosis in patients suspected of having cancer. As such, they are often responsible for orchestrating the patient’s care, including coordination with medical oncologists and radiation oncologists. The role of the surgeon evolves from the fact that at one point, surgery was the only treatment for cancer, and even with the advent of chemotherapy and radiation, surgery was the first step in multidisciplinary care. Over the past several years, the use of other modalities prior to surgery, known as neoadjuvant therapy, has increased dramatically for many types of cancer. It is therefore imperative that surgeons treating cancer have an in-depth knowledge of the different types of cancer and the different modalities available for treatment, particularly where neoadjuvant treatment is recommended.

TUMOR NOMENCLATURE

Neoplasms are defined as benign or malignant according to the clinical behavior of the tumor. Benign tumors have lost normal growth regulation but tend to be surrounded by a capsule and do not invade surrounding tissues or metastasize.

Benign tumors are generally designated by adding the suffix -oma to the name of the cell of origin. Examples include lipoma and adenoma. The term cancer normally refers to malignant tumors, which can invade surrounding tissues or metastasize to distant sites in the host. The nomenclature of malignant tumors is typically based on the cell’s embryonal tissue origins. Malignant tumors derived from cells of mesenchymal origin are called sarcomas. These include cancers that derive from muscle, bone, tendon, fat, cartilage, lymphoid tissues, vessels, and connective tissue. Neoplasms of epithelial origin are called carcinomas. These may be further categorized according to the histologic appearance of the cells. Tumor cells that have glandular growth patterns are called adenocarcinomas, and those that resemble squamous epithelial cells are called squamous cell carcinomas. Cancers composed of undifferentiated cells that bear no resemblance to any tissues are designated as “poorly differentiated” or “undifferentiated” carcinomas.

Tumor Grade

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