For many years, surgeons have accepted the old maxim that the smaller the cancer, the bigger the operation should be. It has been said that the chances of cure are best when a small cancer, without apparent metastasis, is treated by wide removal of the primary tumor and the lymphatics and lymph nodes that drain it. On the other hand, many surgeons believe that patients with advanced cancers that have metastasized extensively to nodes often should be treated palliatively by relatively small operations. There is mounting evidence from the field of immunology that the old adages are false and their opposites may be true. It now seems that removal of uninvolved regional nodes that drain small tumors may lower the patient's immunologic resistance to the implantation and growth of distant metastases. On the other hand, radical removal of large cancers and the nodes to which they have metastasized may prolong