Locoregional Treatments in Surgical Oncology

Locoregional treatments have become a cornerstone in the multidisciplinary management of solid tumors in surgical oncology. These strategies include advanced surgical procedures such as cytoreductive surgery (CRS) with HIPEC, image-guided ablative techniques including IRE, minimally invasive intraperitoneal approaches such as PIPAC, regional perfusion strategies including HAIP and ILP, and targeted embolization methods such as TACE and TARE, sparing surrounding healthy tissues and limiting systemic toxicity. By concentrating treatment on the primary tumor or metastatic deposits—especially in the liver, pancreas, peritoneum, and soft tissues—locoregional therapies provide precise local control. They are particularly beneficial in patients with oligometastatic disease, where the limited metastatic burden allows aggressive local intervention. Such approaches can significantly prolong overall survival, enhance quality of life, and convert initially unrespectable tumors into resectable ones when integrated with modern systemic therapies. In today’s era of personalized oncology, locoregional modalities complement systemic treatments such as chemotherapy, targeted agents, and immunotherapy. They effectively manage local disease progression that systemic therapy alone may fail to control and serve as powerful down staging tools, making borderline or inoperable tumors amenable to curative-intent surgery. Moreover, many of these techniques are minimally invasive, promoting faster recovery, reduced overall morbidity, and the potential for repeated interventions when needed.