This is exactly why I NEVER do this. If the surgeon feels that an operation is essential, I’d prefer maximally debunking surgery with extensive clipping of involved regions followed by chemo-radiotherapy. This has been my strategy for many years, including Moffitt and MD Anderson. We have publ...

I have come across this problem before also. But my current practice is to advise preoperative chemoradiation but take the dose up to 60 Gy (I discuss this with the surgeon first to make sure they are comfortable with that dose- most seem to be). That way, if the surgeon decides that surgery is not ...