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

From the Director's Desk

In-Person Meetings

Heidi Nelson, MD, FACS

Heidi Nelson, MD, FACS
Medical Director, ACS Cancer Programs

For the last 18 months, we have all done a remarkable job of transitioning from in-person meetings and workshops to virtual gatherings to keep ourselves safe while still attending to the needs of the programs. We have educated, trained, produced, published, recruited, site visited, and accredited despite the constraints associated with the pandemic. This is quite an accomplishment when you consider just how many people are involved in the American College of Surgeons (ACS) Cancer Programs, from the leaders and members of the 30+ committees; the Cancer Liaison Physicians, registrars, administrators, and health care professionals within the accredited programs; the site reviewers; state chairs; member organizations; and staff. It also speaks loudly to our resilience and adaptability. In each moment we knew there were jobs to be done, and so we leaned in to do whatever it took. As we see sports stadiums and music halls fill with people, now is probably a good time for us to reflect on the value and future role of in-person meetings.

Historically, in-person meetings were a way for people to come together and share their successes and challenges in order to seek new solutions, build networks, and reinforce communities and purpose. They also were a way in which new ideas, products, and services could be introduced while soliciting feedback or offering promotion through the process of socialization. Education and training in new standards or new tools also were historically conducted in person, and while it is clear that some education and training can be hosted online, there are gaps that occur when only online approaches are used. Based on what we now know, it is likely that virtual meetings will remain relevant for simple activities and messaging, while the in-person meetings will play a larger role in the more complex and in-depth activities. As the ACS staff return to the office two days a week in mid-October, we hope to generate greater insight into how to work and gather in this new hybrid world. Stay tuned!

Clinical Congress Sessions Focus on Diseases of the Liver

Clinical Congress is entirely virtual this year! Tune in to the sessions below focusing on liver cancer and metastatic disease of the liver. Georgios Tsoulfas, MD, PhD, FACS, of Greece moderates both sessions.

On Tuesday, October 26 at 10:00 am CT, PS424, Hepatocellular Carcinoma: When Is the Right Time for Surgical Intervention?, will be co-moderated by Luca Cicalese, MD, FACS.

Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death worldwide. Risk factors for the disease include chronic hepatitis B and hepatitis C, alcohol addiction, metabolic liver disease, and exposure to dietary toxins such as aflatoxins and aristolochic acid. All these risk factors are potentially preventable, highlighting the considerable potential of risk prevention for decreasing the global burden of HCC. HCC surveillance and early detection increase the chance of potentially curative treatment; however, HCC surveillance is substantially underutilized, even in countries with sufficient medical resources.

On Monday, October 25 at 2:00 pm CT, PS363, Liver Transplantation for Colorectal Hepatic Metastatic Disease: Different Practices around the World, will be co-moderated by John J. Fung, MD, FACS.

Colorectal adenocarcinoma is a common malignancy around the world. A recent study (SECA-II study) from Oslo showed that patients with nonresectable, liver-only, colorectal liver metastases (CRLV), at least 10 percent response to chemotherapy, and time from diagnosis to liver transplant (LT) of more than one year demonstrated an overall five-year survival of 83 percent. Also, the use of small liver graft in combination with two-staged hepatic resection for CRLM as a clinical trial has been launched in Germany. A long interval from diagnosis to LT, 12 to 24 months, may improve long-term survival. On the other hand, in most other countries, LT indications for liver metastasis are limited to neuroendocrine cancer. In this panel, experts in this field will present their recent data and share the perspectives of liver transplantation for CRLM.

Visit Clinical Congress 2021 to learn more about the meeting and to register.

Learn more about cancer programming at this year's Clinical Congress. Information will be added to that page and included in this newsletter as it becomes available.

Return to Screening PDSA and Clinical Study: September Screening Numbers and Interventions

For Commission on Cancer (CoC)- and National Accreditation Program for Breast Centers (NAPBC)-accredited programs participating in the Return to Screening PDSA and Clinical Study, please remember to record your post-intervention monthly screening rates for September 2021. Programs need to monitor and record monthly screening rates from April 1 and continue through November 30, 2021.

Programs only participating in the PDSA will input this information on the writeable forms located online within the Return to Screening page.

Programs participating in the clinical study should continue to enter their information each month through REDCap. The REDCap form B/C can be opened and edited at any time before the final submission. Please utilize the "Save and Return Later" button at the bottom of the form.

We have received several questions regarding updates to form A in REDCap and access to form B/C. For assistance, please e-mail Jessica Dangles ( and include the name and e-mail of the individual who completed the form (this may be different from your PI) and disease site.

Download Breast Cancer Awareness Month Resources

2021 Breast Cancer Awareness PosterOctober is Breast Cancer Awareness Month, an international annual event devoted to increasing awareness of breast cancer.

In 2021, an estimated 281,550 new cases of invasive breast cancer will be diagnosed in women; 2,650 cases diagnosed in men; and an additional 49,290 cases of ductal carcinoma in situ (dcis) diagnosed in women in the United States. An estimated 44,130 people will die from the disease (43,600 women, 530 men).

The CoC and the NAPBC have created posters and other resources to support your outreach activities to increase awareness of breast cancer within your community this month.

Approved staff at CoC-accredited programs can access the Breast Cancer Awareness Month resources by logging into CoC Datalinks with their username and password. Under "Resources," please click on the "Resources to Market CoC-Accreditation" link to gain access to all of our marketing resources.

Approved staff at NAPBC-accredited programs can access the Breast Cancer Awareness Month resources by logging into the NAPBC QPort with their username and password and clicking on "Marketing Resources."

Please share how you observe this event by sending your articles, activities, and photographs to

Dr. Hunt Discusses Technical Standards for Cancer Surgery

In the September 21 issue of the Bulletin Brief, Steven D. Wexner, MD, FACS, FRCSEng, FRCSEd, FRCSI(Hon), FRCSGlasg(Hon), Vice-Chair, American College of Surgeons Board of Regents, and director, Digestive Disease Institute at Cleveland Clinic Florida in Weston, FL, interviewed Kelly K. Hunt, MD, FACS, FSSO, Chair, ACS Cancer Research Program (CRP), and professor and chair, MD Anderson Cancer Center. Dr. Hunt discussed ACS CRP and the Technical Standards for Cancer Surgery: Bringing Evidence into Practice course that will take place during Clinical Congress 2021.