Randomized Controlled Trials in Surgical Oncology:. Where Do We Stand?

This article reviews the history of clinical trials in surgery using breast cancer surgery and rectal cancer surgery as examples. Trials in breast cancer have transformed the surgical management of this disease. Rectal cancer surgery has also changed greatly, but much of this evolution occurred outside the setting of clinical trials. This article highlights the strengths and limitations of surgical trials and suggests that future studies should include pretrial credentialing as a requirement for surgeon participation. More work needs to be done to bridge the gap from trial results to implementation of new techniques in clinical practice.