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Главная » 2013 » Сентябрь » 16 » Семь порочных методик в хирургической онкологии
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Семь порочных методик в хирургической онкологии

A cavalcade of organizations will issue lists this fall, including a number of cancer-related groups such as the American Society for Radiation Oncology, the Society of Gynecologic Oncology, the American Society of Hematology, and the American Society for Clinical Oncology. Some of the organizations will be issuing recommendations for the second or even third time.

The ACS list can be used to "support conversations between patients and physicians about what care is really necessary," according to a press statement.

"This initiative will help provide cancer patients with a highly credible resource to obtain reliable information when discussing certain aspects of their care with their physicians," said David P. Winchester, MD, medical director of the ACS Cancer Programs.

"The American College of Surgeons and the Commission on Cancer have shown tremendous leadership by releasing its list of tests and procedures they say are commonly done in surgery and surgical oncology, but aren't always necessary," said Richard J. Baron, MD, president and CEO of the ABIM Foundation.

The Lists
The ACS has issued the following 2 recommendations:

Do not perform axillary lymph node dissection for clinical stage I or II breast cancer with clinically negative lymph nodes without attempting sentinel node biopsy.

Avoid colorectal cancer screening tests for asymptomatic patients with a life expectancy of less than 10 years and no family or personal history of colorectal neoplasia.
In addition, the Commission on Cancer has issued the following 5 recommendations:

Do not perform surgery to remove a breast lump for suspicious findings unless a needle biopsy cannot be done.

Do not initiate surveillance testing after cancer treatment without providing the patient with a survivorship care plan.

Do not use surgery as the initial treatment without considering whether presurgical (neoadjuvant) systemic and/or radiation therapy can be effective at improving local cancer control, quality of life, or survival.

Do not perform major abdominal surgery or thoracic surgery without a pathway or standard protocol for postoperative pain control and pneumonia prevention.

Do not initiate cancer treatment without defining the extent of the cancer (through clinical staging) and discussing the intent of treatment with the patient.
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