Surgical Clinical Research: A Comic Opera NO MORE

Surgery has an over-arching role every field of cancer, from prevention, diagnosis, treatment (curative, supportive and reconstructive) and palliation. According to the Lancet Commission on Global Surgery 2030, 80% of all cancers need some form of surgical treatment. They estimated the global need for cancer surgery at 32 million operations in 2015 and 45 million by 2030. Thus, the future of cancer treatment cannot move forward unless surgical care and research is included in national and even global priorities.

Surgical research has been branded as a “comic opera” because of the inability of the surgical community to continuously deliver successful randomized clinical trials. In a recent publication by Evrard, et al, “From a Comic Opera to SURCARE: An open letter to whom clinical research in surgery is of importance”, the challenges of surgical research have been identified and proposals to overcome them have been discussed. These strategies include alternative research methodologies that can be more applicable to addressing surgical questions or use of innovative techniques or devices, quality control measures in a surgical trial and the use of prospective observational studies to complement randomized clinical trials. Likewise, the importance of developing a sustainable surgical research platform and quality assurance infrastructure has been proposed to lead the new wave of high quality surgical trials.

This publication also highlighted the important collaboration by 3 leaders in the field of surgical oncology and research: The European Organization for Research and Treatment of Cancer (EORTC), European Society of Surgical Oncology (ESSO) and Japan Clinical Oncology Group (JCOG). Together, they are building SURCARE: “High Quality Standards for Prospective Surgical Clinical Research”. This infrastructure has several components: a framework to implement QA methodology for surgical trials, a platform to develop prospective and multidisciplinary studies, a global network of surgical researchers, educational program for a new generation of surgeons oriented to the culture of research, and a platform to facilitate greater patient involvement in research development and surgical outcome monitoring.

“From a Comic Opera to SURCARE,” is calling on, first and foremost, to the surgical community to wake up and take action to regain their voice and leadership in cancer research. Other stakeholders such regulators, funding bodies, research methodologists, and other cancer specialists are called upon to support this initiative and recognize the proposals to improve surgical research. As surgery continues to be a critical step in treatment and the best chance for cure for most cancers globally, these strategies require an urgent and sustained response.

If you are interested to take part in the SURCARE initiative, you can contribute through research ideas, links for networking and pathways for funding for the initiative.  Please contact Carmela.caballero@eortc.be.