American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

2020 ACS Cancer Programs Summer Virtual Meetings – General Sessions

The American College of Surgeons (ACS) Cancer Programs hosted its annual summer meetings virtually July 23-24. In addition to multiple committee meetings, ACS Cancer Programs held several program-specific open general sessions for all members. The American Joint Committee on Cancer (AJCC), Commission on Cancer (CoC), ACS Cancer Research Program and Cancer Surgery Standards Program (ACS CRP and CSSP), National Accreditation Program for Breast Centers (NAPBC) and National Accreditation Program for Rectal Cancer (NAPRC) all hosted general sessions.

Welcome Message from ACS Cancer Programs Medical Director

Welcome Message from ACS Cancer Programs Medical Director Heidi Nelson, MD, FACS

American Joint Committee on Cancer (AJCC)

Friday, July 24, 9:00–10:15 am | Agenda
This year’s AJCC Cancer Department Conference included four key meetings from the Editorial, Education and Promotions, Implementation, and Executive Committees, as well as the Annual General Session convened by AJCC Chair, Robert Brookland MD, FACR, FACRO. The theme of moving beyond print to developing digital content with a living timeline for cancer staging system updates was pervasive throughout the lively and well-attended sessions.

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A special highlight was the AJCC Executive Committee’s enthusiastic endorsement of the new AJCC Cancer Staging Protocol format which will be used starting with the Cervix Cancer Version 9 Staging System.  Benefits of the AJCC content restructuring and software products will keep pace with the technical demands of users and licensees, increasing flexibility while moving forward with science and our AJCC partners in the cancer ecosystem. Dr. Brookland stated, “As the AJCC completes its first major update since the publication of the 8th Edition, Cervix Cancer Version 9 will now be prepared for digital release and implementation on January 1, 2021.”

The AJCC’s Annual Meeting General Meeting was well attended, as Chair Dr. Robert Brookland and AJCC Senior Manger Martin Madera presented the “State of the AJCC 2020,” emphasizing the start of a  new era of moving from book-centric editions and printed matter, to software-based versions of incremental disease site staging system updates. The discussion incorporated the feedback from the recently conducted focus groups with surgeons, pathologists, registrars, and other oncology clinicians that resulted in support for the shift to electronic products.

The session included a moving tribute to our retired AJCC Coordinator, the late Judy Janes, delivered by David Byrd, MD, FACS;  as well as recognition of and thanks to outgoing committee members George J. Chang, MD, FACS; Jonathan A. Cosin, MD, FACOG, FACS; Michael O. Koch, MD, FACS; and Theresa Vallerand, CTR, for their years of dedicated service to the AJCC and its mission.

Discussions in the AJCC Editorial Committee Meeting led by Chair Mary Kay Washington, MD, PhD, began with updates from the active Disease Site Panels, beginning with Cervix Version 9, which is being implemented after an accelerated pace in the first half of 2020. As stated by Mahul Amin, MD, FCAP, “the formal movement into the ninth version update, actually represents a huge milestone.” Dr. Brookland concluded “The work of this committee is so foundational; the AJCC is really blessed to have such strong input from such a diverse group.”

“The Education and Promotions Committee wants to be at the forefront to make sure that our stakeholders and users are aware of important changes in cancer staging,” said AJCC Education and Promotions Committee Chair Alexander Olawaiye, MD, FACS, MRCOG, FACOG. A brisk discussion reviewed ways of promoting AJCC ‘s coming changes to a broader membership, including ways to increase journal publications, as well as podcasting, and reaching out to other organizational newsletters.

The AJCC Implementation Committee, chaired by Jeffery Gershenwald, MD, FACS and co-chaired by Samantha Spencer, MD, began with Dr. Gershenwald’s call to “think about how we can continue to break down natural and artificial barriers between the clinical and registry communities to be nimble” in implementing staging system updates.  Dr. Spencer continued with the major themes for understanding the cancer landscape: serving patient care needs as medicine and science evolve by moving to more personalized data, while harmonizing content and process across different cancer organizations. 

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Recording

 

Commission on Cancer (CoC)

Friday, July 24, 9:00–10:15 am | Agenda
During the CoC General Session, Chair Lawrence Shulman, MD, MACP, FASCO, presented updates regarding several CoC programs and initiatives. The CoC will roll out a new virtual accreditation site review plan and training this fall to accommodate programs whose visits were postponed due to COVID-19. The CoC continues to provide resources to support implementation of the 2020 Standards, including webinars, workshops, and an extensive resource library. Dr. Shulman reported that training will be provided to registrars on the National Cancer Database’s (NCDB) new Rapid Cancer Reporting System (RCRS), which is scheduled for rollout in the fall. Finally, CoC members, State Chairs and site reviewers were encouraged to serve on a new workgroup formed to plan the CoC’s 100th Anniversary celebration in 2022.

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Several panel presentations explored the impact of COVID-19 on cancer care. CoC Quality Integration Chair Daniel Boffa, MD, FACS, discussed strategies for managing the post-COVID-19 surge of patients needing care and the impact of the pandemic on screening.  Dr. Shulman reviewed the medical community’s response to treating cancer patients during the unprecedented challenge of the COVID-19 pandemic. CoC Chair-Elect Timothy Mullett, MD, MBA, FACS, reviewed COVID-19’s impact on cancer program accreditation, as well as the CoC’s  response to the pandemic. 

Dr. Shulman noted that COVID-19 continues to be top of mind for many CoC members.

“Drs. Boffa and Mullet joined me in discussing local, national and CoC responses to the pandemic, with a special focus on strategies we used to continue to provide high-quality cancer care to our patients,” said Dr. Shulman.  “The oncology community and CoC displayed remarkable resolve and agility in meeting the challenge, always focused on the needs of our patients.”

 

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Recording 

 

National Accreditation Program for Breast Centers (NAPBC)

Friday, July 24, 9:00–10:15 am | Agenda
The focus of the National Accreditation Program for Breast Centers (NAPBC) general session was increasing the value of accreditation and was led by Chair Scott Kurtzman, MD, FACS. Dr. Kurtzman commenced the session by introducing Megan Pfarr, DPT, CLT, a new board organization and representative from the American Physical Therapy Association, then followed with an overview of NAPBC recent activities starting with the NAPBC’s response to the COVID-19 pandemic.

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To date, efforts by the NAPBC include forming a consortium to create recommendations for prioritization, treatment and triage of breast cancer patients during the COVID-19 Pandemic, followed by COVID-19 Breast Cancer Consortium’s Considerations for Re-entry and conducting the CROWN Study: COVID-19 Related Oncologist’s Concerns about treatment Delays. Additionally, the NAPBC collaborated with member organization partners and friends to host three very well attended webinars.

Dr. Kurtzman also shared the revised NAPBC mission statement: “The NAPBC represents a consortium of national, professional organizations dedicated to the quality of care of patients with diseases of the breast” and introduced current NAPBC officers and committee leadership and thanked site reviewers for representing the NAPBC.

Highlights from the Value of Accreditation survey were reviewed along with the strategic framework and the three strategic priorities developed in response to the survey results. Task forces assigned to address these strategic priorities reported on how they will work to achieve the goals set for each of them.

Task Force 1 is addressing how the NAPBC can better serve its centers. After surveying centers, the task force conducted follow-up interviews with some respondents and will use the results of those conversations to determine focus areas going forward. Task Force 2 is addressing how to best work with member organizations data collection and quality improvement initiatives to benefit the accredited centers.  Task Force 3 is focused on strategies for reaching more patients through accreditation. The task force has developed a plan, communication content and a contact list; however, efforts are on hold until fall due to COVID-19. In the meantime, the task force is working on how to support safety net hospitals in cities with the largest breast cancer disparities.

Committee reports from Standards & Accreditation (including Virtual Site Visit Plans), Education & Dissemination, Quality Improvement & Information Technology, Advocacy & Outreach covered accomplishments and status updates on current projects and planned events.< p>

Katharine Yao, MD, FACS provided an update on the CROWN Study which looked at how COVID-19 is impacting time to treatment and physician wellness.  The results of the study will be shared with the group once all the data has been analyzed.

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Recording

 

National Accreditation Program for Rectal Centers (NAPRC)

Friday, July 24, 9:00–10:15 am | Agenda
James W. Fleshman Jr, MD, FACS, Vice Chair of the National Accreditation Program for Rectal Cancer (NAPRC), lead off the NAPRC general session with an overview of the results of the NAPRC’s Strategic Retreat that took place in January 2020. He shared each committee’s progress and plans toward meeting the initiatives identified in the strategic plan.

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NAPRC Site Reviewer, Linda Farkas, MD, FACS, closed the general session by reviewing the draft plan for NAPRC virtual site visits that will be piloted this Fall. The attendees then brain stormed efficient ways to conduct the medical record review, which is the biggest component of the NAPRC site visit.

NAPRC Chair, Steven D Wexner, MD, PhD (Hon), FACS, FRCS (Eng), FRCS(Ed), FRCSI (Hon), Hon FRCS (Glasg), moderated the general session. He noted that the “significant engagement of the radiologists and pathologists facilitated by the recently-revised standards was greatly appreciated.” Dr. Wexner stated that the “general session was highly informative, stimulating and interactive, leaving the participants energized about the tremendous value of the NAPRC.”

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Recording

 

ACS Cancer Research Program (CRP)/ Cancer Surgery Standards Program (CSSP)

Friday, July 24, 9:00–10:15 am | Agenda
The ACS Cancer Research Program (ACS CRP) and Cancer Surgery Standards Program (CSSP) held a joint general session led by ACS CRP Director and CSSP Vice-Chair Kelly Hunt, MD, FACS, and CSSP Chair Matthew H.G. Katz, MD, FACS. “We received updates on many of the outstanding projects that have been going on within the ACS CRP, and the goals and vision of the new CSSP were shared. We also discussed opportunities for collaboration between the two programs. The session was full of engagement from a diverse range of participants, all of whom share a commitment to improving the quality of surgical research and surgical care,” said Dr. Katz after the session.

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Presentations on projects from each of the ACS CRP committees (Dissemination & Implementation, Cancer Care Delivery Research, Education, and Cancer Care Standards Development) were given by ACS CRP leaders and members.

Abigail Caudle, MD, MS, FACS reviewed her Tumor Board Video projects which aim to disseminate trial data from the ACOSOG Z1071 (Sentinel Lymph Node Surgery After Neoadjuvant Chemotherapy in Patients with Node-Positive Breast Cancer) and Alliance A021101 (Preoperative Modified FOLFIRINOX Treatment Followed by Capecitabine-Based Chemoradiation for Borderline Resectable Pancreatic Cancer)/Alliance A021501 (Combination Chemotherapy With or Without Hypofractionated Radiation Therapy Before Surgery in Treating Patients With Pancreatic Cancer) clinical trials through Tumor Board settings. Kaitlyn Kelly, MD, MAS, FACS, followed by presenting interim results from her similar Tumor Board Video project which utilizes a 10-minute video summarizing evidence-based and guideline recommendations on the staging and treatment of gastric cancer.

Rebecca Snyder, MD, MPH, FACS, shared results from the 2015 special study on post-treatment surveillance in breast, colon and lung cancers, including documentation of cancer recurrence within the NCDB. Dr. Katz then presented an overview of educational efforts within the Cancer Care Standards Development Committee, including an upcoming didactic course on technical standards for cancer surgery and the Operative Standard for Cancer Surgery video series. ACS CRP Education Chair Judy Boughey, MD, FACS, gave updates on the ACS CRP didactic course held at Clinical Congress 2019 (“Designing and Running a Prospective Surgical Clinical Trial”) which has now been adapted as an online course.

To end the session, Dr. Katz gave a brief overview of the CSSP, the new ACS Cancer Program which launched in late July and aims to improve cancer care by implementing evidence-based standards for the technical conduct of oncologic surgery and educating surgeons to help them meet those standards.

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Recording

 

ACS Cancer Programs

Friday, July 24, 10:30–11:30 am | Agenda
ACS Cancer Programs Medical Director Heidi Nelson, MD, FACS, led a session that reviewed the recent achievements of the programs, as well as the challenges faced during the past year. Cancer Programs leadership improved operational efficiency and effectiveness, harmonized and coordinated operations, and increased engagement of stakeholders. These successes were achieved despite the unprecedented challenges of the COVID-19 pandemic, as well as increasing clinical complexity and the emergence of digital technologies.

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CoC Chair Lawrence Shulman, MD, MACP, FASCO; NAPBC Chair Scott Kurtzman, MD, FACS; and NAPRC Chair Steven Wexner, MD, PhD(Hon), FACS, FRCS(Eng), FRCS(Ed), FRCSI(Hon), FASCRS(Hon), FRCS(Glag), presented accreditation program updates, focusing on their programs’ responses to the COVID-19 pandemic. Leadership developed COVID-19 cancer surgery triage documents and cancer care webinars and promoted the CROWN study to assess the pandemic’s impact on breast cancer treatment and physician well-being. In addition, Cancer Program chairs discussed site review postponements and accommodations due to COVID-19.

CoC Quality Integration Chair Daniel Boffa, MD, FACS, discussed the upcoming launch of the National Cancer Database’s (NCDB) Rapid Cancer Reporting System (RCRS) and STORE Manual reduction. ACS CRP Chair Kelly Hunt, MD, FACS, reported on the resumption of Alliance/ACS CRP National Cancer Institute Community Oncology Research Program (NCORP) Cancer Care Delivery Research (CCDR) trials, as well as new resources including the Tumor Board Video Series. CSSP Chair Matthew Katz, MD, FACS, discussed the recent launch of the new program. Early CSSP initiatives will focus on content development, implementation and education on the synoptic operative reports for breast, colon and melanoma. AJCC Chair Robert Brookland MD, FACR, FACRO, provided an update on the AJCC cancer staging 9th edition work including development of the new cervix staging protocol and release of the AJCC cancer staging APIs.

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Recording