Al-Refaie Waddah B, Vickers Selwyn M
Department of Surgery, Surgical Outcomes Research Center, University of Minnesota and Minneapolis VAMC, MMC# 195, 420 Delaware Street Southeast, Minneapolis, MN 55455, USA.
Adv Surg. 2012;46:269-81. doi: 10.1016/j.yasu.2012.05.001.
Cancer trials represent a rigorous and clear approach to testing whether an intervention or treatment will alter the outcomes of individuals with cancer in an experimental manner that is beyond the level of observational studies. As such, they remain useful and valid to the day-to-day practice of general surgeons and surgical oncologists. However, the shortcomings of current cancer clinical trials need to be recognized, especially when less than 1% of adults persons with cancer participate in cancer clinical trials, thus leaving the ability to generalize these trials to patients and their surgeons in the real-world setting an open question. Moving forward, physicians, payers, professional societies, advocates, the NCI, and other stakeholders need to develop broader cancer trials to benefit the millions of patients with cancer in the United States.
癌症试验代表了一种严谨且明确的方法，用于以一种超越观察性研究层面的实验方式，测试一种干预措施或治疗方法是否会改变癌症患者的预后。因此，它们对于普通外科医生和外科肿瘤学家的日常实践仍然有用且有效。然而，当前癌症临床试验的缺点需要被认识到，尤其是当参与癌症临床试验的成年癌症患者不到1%时，这使得能否将这些试验推广到现实世界中的患者及其外科医生身上成为一个悬而未决的问题。展望未来，医生、支付方、专业协会、倡导者、美国国立癌症研究所（NCI）以及其他利益相关者需要开展更广泛的癌症试验，以使美国数百万癌症患者受益。
