Abstract
Surgery of Local Recurrences is conditioned by the ″radicality of previous surgery, the likelihood of total ressection, the histological type, the response to chemotherapy, prognoses, sensitivity to radiotherapy and absence of metastatic lesions (unless those are amenable to surgical ressection). Surgery for metastatic cancer implies that all metastatic lesions can be excised and the primitive tumour is or can be controlled. In both cases a good general health of the patient is a prerequisite for surgery of recurrence or metastases. The most difficult decision is option between ″radical″ treatment or just paliation, in order not to jeopardize the quality of life of the patient during his remaining life span. Several examples are presented, from abstention to radical surgery. Treatment must be individualized and take into account previous treatments, probability of response to alternative treatment methods and overall prognoses. If the above criteria are respected, surgery remains an essential step for the cure of recurrent or metastatic solid tumours in children.
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