Abstract
Tumor debulking of gastrointestinal tumors for the reduction of tumor mass is intended to improve subsequent treatment efficacy. However, in advanced malignant disease, this therapy is often associated with increased morbidity and lethality. Adjuvant therapies cannot be initiated when needed. Therefore, long-term survival remains unaffected. Advances in biomedical science provide preliminary explanations for these therapeutic problems. Modern therapeutic concepts like neoadjuvant therapy for locally advanced tumors are based on these findings. The probability of complete R0 resections, necessary to improve long-term survival, can be enhanced by these therapies. The ongoing prospective neoadjuvant studies for gastrointestinal tumors are already very encouraging.
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