The adoption of aggressive surgery in the Russian Cancer Research Center during recent years as the main treatment philosophy in cancer patients including those at a high and very high risk is very closely connected with appropriate anesthesia and postoperative intensive care. Several organization issues, including technical supply, are discussed in this paper. A concept of anesthesiological support of patients during highly traumatic surgery is presented. The authors share their opinions on infusion therapy, massive blood loss, therapy of perioperative organ and multiple organ failure and sepsis in the light of modern concept of systemic inflammatory response.