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EXECUTIVE DIRECTOR’S REPORT
The manual was envisioned as a response to the
need for minimum evidence-based standards for various cancer procedures and as a reference tool for clinical trials that include surgical interventions for four
common disease sites: breast, colon, lung, and pancreas.
Procedures covered in Operative Standards for Cancer Surgery include breast-conserving surgery, pancreaticoduodenectomy, and lobectomy. The focus is on describing
technical elements critical to proper conduct of cancer
operations where best practices can be demonstrated.
The authors have attempted to use the best evidence
available, and this evidence represents the opinions of
diverse and representative groups who care for cancer
patients. Expert clinicians and researchers provided
invaluable input that was used to develop the guidelines, and a Town Hall Meeting at the 2013 Clinical
Congress provided an opportunity for attendees to
learn about how the standards were created.
Benefits for researchers, clinicians, and patients
As is the case for all health care disciplines, the body
of evidence of scientifically verifiable ways of performing cancer procedures is growing. This reference tool
will spare clinical trial investigators the difficulties of
establishing or re-establishing the basic principles of
these operations with each new trial. Furthermore, having a set of protocols will minimize variability across
study sites and improve adherence to best practices for
patients receiving care both on and off a clinical trial.
It should also be useful in addressing variability in
clinical practice. Much of clinical surgery is based on
principles of ablation, correction of anatomic deficits,
and reconstruction. The effectiveness of cancer operations has generally followed the principle of surgical
removal of the malignancy. The technical elements
that are critical to the proper conduct of a cancer operation ensure the use of best practices and optimal long-term outcomes.
When evidence and experience demonstrate that
a procedure is essential for safe, effective, long-term
outcomes, it is important to teach that technique with
precision and put it forth as an evidence-based standard.
As the project evolved, it became clear that this manual
could also serve as an instructive text for surgical education and training.
Hence, this manual, using both text and illustrations, is not merely a surgical atlas, but rather is in
many ways a textbook that emphasizes the critical
steps in performing an operation and intraoperative
decision making. It further can be used to provide a
template for operative reports and it would be useful
to the individual surgeon in analyzing his or her performance measures.
Defining those critical elements of each operation
that are essential for surgical success is the purpose of
Operatives Standards for Cancer Surgery, and the areas
covered have achieved this noble goal. Drs. Nelson and
Hunt and the other surgeons who led the disease site
groups are to be commended for the work they have
done in producing this landmark approach to surgical
cancer care and for this latest addition to the College’s
resources for surgeons seeking to provide optimal care.
This effort will become the yardstick by which cancer
care is measured going forward and should be a standard for how all of surgical care is taught. ♦
The manual was envisioned as a response to the need for minimum
evidence-based standards for various cancer procedures and as
reference tool for clinical trials that include surgical interventions
for four common disease sites: breast, colon, lung, and pancreas.