Surgical research in cancer
Capacity issues in UK surgical research
Surgery is an important part of many cancer patients’ journeys, and the NCRI 2008–2013 strategic plan raised concerns about the UK’s capacity to undertake surgical research. Analysis of the NCRI’s Cancer Research Database showed a low overall volume of surgical research in cancer. This parallels the situation in surgery beyond cancer, as the Royal College of Surgeons of England (RCS England) found in their 2011 publication.
NCRI has launched the Future of Surgery workshop series, bringing together experts to deal with challenging, cross-specialty topics and influence the future of surgery research in cancer. Five workshops will took place between May 2016 and March 2017, each will produce a report that brings together expert opinion and identifies potential next steps for surgery research in cancer. The first and second workshops were covered in editorials in The Lancet.
The workshops will not be one-way education from those speaking to those attending. Instead, they will take the form of expert working meetings, drawing on the expertise of all those attending to build consensus, identify gaps in knowledge, or propose ways that things could be done differently in surgery research in cancer. Workshop leads have now been appointed. The five workshop topics and dates are:
- 4 May 2016: Outcome measures in surgery studies, led by Mr Angus McNair. Looking beyond overall survival, what are the key surgical endpoints? Powering studies to make endpoints statistically meaningful and change surgical practice.
» “Trials are only as credible as their endpoints”: Defining the future outcomes surgical research
- 20 September 2016: Technology trials in surgery, led by Mr Stephen Price. Discussing the evidence required prior to introduction of new technologies into surgical practice. Ways to incentivise surgeons to evaluate new technologies.
» “Technology Trials in Surgical Oncology”: What evidence is required prior to introduction of new technologies into surgical practice?
- 23 November 2016: Selecting patients for surgery, led by Ms Lynda Wyld. Algorithms to predict benefit and identify which patients will benefit from surgery. Frailty in cancer surgery – how can surgeons design and select tools for clinical application, and determining prevalence of frailty? Decision support tools for patients.
» Selecting patients for surgery
- 17 January 2017: Extent of surgery, led by Mr Stuart McIntosh. Designing and delivering pre-surgical trials; Role of surgeons in window of opportunity studies; How to evaluate the extent of surgery in clinical trials
» Extent of Surgery and peri-surgical trials
- 21 March 2017: Surgery for metastatic disease, co-led by Mr Prasanna Sooriakumaran & Mr Hassan Malik. Resection of metastatic disease; Surgery vs systemic therapy;Surgical and other loco-regional treatment of metastatic disease to lung, liver, bone and brain; Management of the primary tumour in the presence of metastatic disease; Imaging metastatic burden
» Surgery for Metastatic Disease
The plan for each workshop has been overseen by the NCRI Future of Surgery steering committee, which includes senior research surgeons and an NCRI representative, to ensure it fits with the overall programme of events. NCRI Future of Surgery steering committee
- Professor Richard Shaw
- Professor Nigel Bundred
- Mr Simon Bach
- Mr Grant Stewart
- Dr Seema Alexander