The Surgical Committee is an integral part of the structure of Children's Cancer Study Group (CCSG) a cooperative group designed to carry out clinical trials in pediatric patients with leukemia and solid tumors. The membership of the Surgical Committee, CCSG, consists of 156 surgeons, from five surgical specialties, divided into three major committees: Advisory, Steering, and the Surgical Membership. Committee functions include: (a) Participation in the development of protocols for, and conduct of, those clinical studies, which include a significant operative procedure, including preparing the appropriate sections of these protocols; (b) Initiation of special studies in areas of particular concern to surgeons; (c) Provision of communication opportunities for CCSG surgeons in all specialties, relative to the rationale, methods and the detailed requirements of the surgical procedures which are included in trials. For this purpose, both regular CCSG Group Meetings (3/yr) and special meetings held at the sites of national surgical organizations are employed; and (d) Monitoring the date relative to surgical procedures in CCSG trials in respect to compliance with protocol intent. This includes primarily reviews by study carried out by surgical members of specific study committees (approximately 700/yr). The purpose of these reviews is to establish eligibility for the study, effectively stage patients in Group trials, and develop uniformity in the application of secondary and tertiary procedures for evaluation or tumor excision. In areas of special interest to members of this Committee, special studies are initiated. Examples of these (1980-82) are: (a) Evaluation of the significance of lymph node dissemination in neuroblastoma; (b) The influence of various histologic subtypes on prognosis in osteosarcoma; (c) The results of limited surgical procedures, attempting to avoid pelvic exenteration in rhadomyosarcomas of the distal genitourinary tract; (d) Appropriate indications for resection of pulmonary metastatic nephroblastoma, and for renal resection in bilateral nephroblastoma; (e) The long-range complications of laparotomy-splenectomy in Hodgkin's Disease in Childhood; and (f) Factors contributing to compliance with surgical protocol in Group studies, and the influence of informational programs on these factors.
