The distinctive features of surgical oncology as a specialty: considerations for Chinese surgeons

In China, as in the United States and other countries, cancer patients will increasingly receive more than one modality of treatment delivered by cancer physicians from different medical specialties (e.g., internal medicine and surgery). In the United States and in many other countries, the surgical specialization, known as "surgical oncology" has grown as an essential part of cancer care delivery in the United States, both in academic medical centers and in the majority of cancer centers and hospitals in the local community. At a broad level, one can define the roles and responsibilities of a surgical oncologist as follows: (I) an excellent surgeon who can safely manage cancer patients through complex operations and have the judgment to know what operations to select; (II) knows how to integrate surgical treatment as part of a multidisciplinary team, including the type and timing of surgery after pre-operative systemic therapies and/or radiation therapies; (III) participates as an oncologist in the long-term disease-management of cancer patients; and (IV) participates in cancer clinical research and/or translational research. Perhaps the most compelling reason for surgical specializations is the evidence from multiple studies in the United States and Europe that "high volume" cancer centers and surgical specialists have better outcomes for treating complex or advanced cancers. It is important for all surgeons treating cancer patients to keep up to date with advances in oncology and be a partner with medical and radiation oncologists in providing contemporary multidisciplinary cancer care and to participate actively in cancer clinical trials where they are available. The uniqueness of our specialty is to function as both a surgeon and an oncologist in the management of the surgical patient with cancer.