Knowing when not to operate on cancer: the essence of surgical oncology and the challenge for the mentor. Surgical Oncology

摘要

As our ability to "treat" patients with advanced malignancies continues to progress, cancer surgeons are continually faced with the dilemma of how far to push the envelope of our capabilities. Because the cost of health care in America has now reached 14.9% of the Gross National Product, there will be increasing scrutiny of our activities as physicians. Despite Medicare regulations, more restrictions regarding payment for off-label use of chemotherapy agents and other drugs may be forthcoming.1 From a surgical perspective, the risk-benefit analysis for a given procedure in a given patient will become an increasingly important analysis in our approach to surgical therapy for patients with cancer. It is also obvious that quality indicators will soon be considered in reimbursement to hospitals and physicians.