Abstract
Thiseditorialisadirectresponsetothatchallenge,withitsmainstatedpurposebeingtodocumentthe complications of frontline aggressive surgical approach.The authors restrict their analysis to a select group ofpatients treated in a more recent time period at their owninstitutions, the Istituto Nazionale Tumori in Milan and theInstitute Gustave Roussy, Villejuif near Paris and serving alarge metropolitan area. Thus, the authors appropriatelytarget a group of patients who all underwent frontlineaggressive surgical approach, although they were not allincluded in the two previous Journal of Clinical Oncologyreports. However, it seems that the same basic methodologythat was applied in the original articles was again used ingathering data on operative complications—that is, retro-spective review of patient charts. This methodology isnotoriously flawed and has been reported to consistentlyunderestimate morbidity by 30–50%.
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