Observations on surgical oncology and the Livre blanc.

A high standard of surgical care is the most crucial factor in determining outcome for the great majority of patients with solid malignant tumours. Although acknowledged by most experts this fact is insufficiently recognised by the medical community, by health administrators, by the lay public or by political decision-makers. Difficulty in appreciating the importance of quality in surgery may have come about because of the changing role of the surgeon in cancer care. While remaining the most important instrument in curative cancer treatment, surgery has been joined by other modalities active against malignant disease.