Technical Standards for Cancer Surgery: Commission on Cancer Standards 5.3-5.8

Clinical practice guidelines in oncology have typically focused on workup, disease staging, and medical management. Although recommendations for surgical care have been included in these guidelines, those recommendations have primarily addressed issues such as the role of surgery or the incorporation of surgery into multidisciplinary treatment strategies, not the technical performance of the operative procedures themselves. Therefore, the quality of surgery, the only component of multidisciplinary cancer care proven to be potentially curative, has been poorly controlled. During the past decade, the American College of Surgeons (ACS) cancer programs have attempted to fill this gap by developing "operative standards" for cancer surgery. This report discusses the history of the operative standards, highlights evidence to demonstrate their efficacy, and describes the activities of the ACS Commission on Cancer and Cancer Surgery Standards Program toward disseminating and implementing them.