September 1, 2022
The ACS Cancer Research Program (CRP) recently released the third volume of Operative Standards for Cancer Surgery, a valuable resource for both oncology surgeons and general surgeons. Now available in digital and print, Volume 3 provides evidence-based recommendations on the technical conduct of cancer operations for sarcoma, adrenal, neuroendocrine, peritoneal, urothelial, and hepatobiliary cancers.
Surgeons have increasing demands on their time, making it challenging to keep abreast of the latest research and integrate it into practice. “With any component of care, there is evidence of what is effective, but there is accompanying variability in actual practice,” said David B. Hoyt, MD, FACS, Immediate Past-Executive Director of the ACS. The goals of Operative Standards for Cancer Surgery are to address that variability and ease the burden on surgeons. The authors of these volumes—diverse teams of experts from organizations across the country—analyzed and distilled the best-available evidence into concise standards, making it easier for surgeons to incorporate evidence-based techniques into daily practice.
Like the previous two volumes, Volume 3 breaks down the components of major cancer operations for each of the six disease sites into critical elements—the steps from incision to closure that ensure the best outcomes for cancer patients. Using clear, concise text and more than 150 illustrations, the authors describe how each critical element should be performed based on a review of available literature and expert opinion and explain the rationale and level of evidence behind the recommendation. In addition, the authors analyze the evidence surrounding identified areas of controversy or key questions, which represent important areas of future investigation. Each section also includes a synoptic operative report template that lists data elements and responses deemed important to document for each operation. Synoptic operative reports allow for more accurate and streamlined data collection.
The Operative Standards for Cancer Surgery provide a unique resource to surgeons. “Although guidelines for multidisciplinary cancer care exist from many sources, these manuals represent the only large compendium of standards that specifically inform the technical conduct of surgery,” said Matthew Katz, MD, FACS, Chair, ACS Cancer Surgery Standards Program.
Nine disease sites, representing some of the most common cancers, were covered in Volumes 1 and 2. Volume 1 was published in 2015 and provided recommendations for the breast, lung, pancreas, and colon. Three years later, Volume 2 was released, covering thyroid, gastric, rectum, esophagus, and melanoma. With Volume 3, the Operative Standards for Cancer Surgery expands to cover sarcoma, adrenal, neuroendocrine, peritoneal, urothelial, and hepatobiliary—more uncommon cancers in which standardized recommendations are particularly valuable.
“Due to the rarity of the disease, there is less evidence and more heterogeneity in the way surgeons conduct operations,” said Christina L. Roland, MD, FACS, Chair, ACS Cancer Care Standards Development Committee and Co-Chair, ACS Sarcoma Section of Operative Standards for Cancer Surgery, Volume 3. “Defining technical standards for rare diseases is critical for improving outcomes.”
After Volumes 1 and 2 were published, the ACS CRP recognized the gap between publication of standards and incorporation into practice. To fill that void, select standards from Volumes 1 and 2 are now included in the Commission on Cancer (CoC) 2020 accreditation standards, Optimal Resources for Cancer Care. Standards 5.3 through 5.8 establish evidence-based best practices for operations conducted for breast cancer, colon cancer, lung cancer, melanoma, and rectal cancer.
Those standards “are now being implemented at CoC-accredited centers nationwide and will help to ensure that cancer surgery is performed at these centers to the highest standards possible,” said Dr. Katz. He anticipates that, as with Volumes 1 and 2, select technical standards in Volume 3 will be incorporated into CoC standards in the future.
Operative Standards for Cancer Surgery, Volume 3, is an essential guide for surgeons who are focused on delivering high-quality care and achieving the best outcomes for their patients.
Order a copy online at facs.org/oscs. For more information, contact cancerresearchprogram@facs.org.
Susan Deming, PMP, is Senior Creative Project Manager, ACS Division of Integrated Communications, and former Project Manager, ACS Cancer Research Program and Cancer Surgery Standards Program, Division of Research and Optimal Patient Care, Chicago, IL.