Department of Surgery, Division of Surgical Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ann Surg Oncol. 2024 Oct;31(10):6378-6386. doi: 10.1245/s10434-024-15624-y. Epub 2024 Aug 1.
In response to growing evidence that proper performance of operative techniques during cancer surgery is associated with improved patient outcomes, the American College of Surgeons (ACS) implemented six operative standards as part of Commission on Cancer (CoC) accreditation. This study aimed to assess surgeon familiarity with these standards when first introduced and 2 years after their adoption.
The ACS Cancer Surgery Standards Program distributed an anonymous 36-question survey to CoC-accredited cancer programs in 2021 and 2023. Questions specific to operative techniques determined the Surgery Score, and those specific to the accreditation standards determined the Standards Score. Mean scores were compared using one-way analysis of variance (ANOVA) and t tests.
The survey was completed by 376 surgeons in 2021 and 380 surgeons in 2023. The Surgery Scores were higher than the Standards Scores in 2021 and 2023. The surgeons who practiced at institutions with CoC accreditation had significantly higher Standards Scores than the surgeons at non-accredited institutions in 2021 (p = 0.005) and 2023 (p = 0.004), but not significantly different Surgery Scores.
The baseline survey in 2021 demonstrated significant knowledge of technical aspects of cancer surgery among a broad surgeon base, but a need for greater understanding of the accreditation standards. The repeat survey distribution 2 years after rollout of the operative standards and associated educational programing showed increased awareness surrounding the operative standards in 2023 and a trend toward improvement in knowledge of the accreditation standards across all specialties. Further evaluation will be directed toward compliance with the accreditation standards.
越来越多的证据表明，在癌症手术中正确执行手术技术与改善患者预后有关，因此美国外科医师学院（ACS）将六项手术标准作为癌症委员会（CoC）认证的一部分。本研究旨在评估外科医生在首次引入这些标准以及采用这些标准两年后对这些标准的熟悉程度。
ACS 癌症手术标准计划于 2021 年和 2023 年向 CoC 认证的癌症项目分发了一份匿名的 36 个问题调查。用于确定手术评分的问题是特定于手术技术的，用于确定标准评分的问题是特定于认证标准的。使用单因素方差分析（ANOVA）和 t 检验比较平均分数。
2021 年有 376 名外科医生完成了调查，2023 年有 380 名外科医生完成了调查。2021 年和 2023 年，手术评分均高于标准评分。在 2021 年（p = 0.005）和 2023 年（p = 0.004），与未获得认证的机构相比，在 CoC 认证机构执业的外科医生的标准评分显著更高，但手术评分没有显著差异。
2021 年的基线调查显示，在广泛的外科医生基础上，对癌症手术的技术方面有了显著的了解，但需要进一步了解认证标准。在实施手术标准和相关教育项目两年后进行的重复调查显示，2023 年对手术标准的认识有所提高，所有专业对认证标准的认识都有所提高。进一步的评估将针对对认证标准的遵守情况。
