The future of trials in surgical oncology.

Patients with cancer generally have better outcomes when treated as part of a clinical trial compared with patients not enrolled in a clinical trial. Unfortunately, surgical participation in, and leadership of such studies, is limited. This lack of clinical investigation is adversely affecting progress in cancer surgery research and, ultimately, hinders the treatment of patients. Some of the reasons for poor surgical participation in clinical research include: limitations on funding provision; inadequate training of junior surgeons in clinical trials methodology; and inadequate support of surgical faculty members as clinical investigators. Despite these shortcomings, numerous successful surgical studies have helped to change concepts, and improve patient care in certain clinical areas. Finally, a number of possible solutions are proposed, which might improve surgical involvement in clinical trials and result in more, and better-designed and executed clinical trials in this important area of research.