ABSTRACT
Cancer surgery puts the patient at risk twice for a poor outcome. The first time is during the initial (usually in hospital) period of diagnosis and treatment. Outcome is expressed as morbidity and even mortality. Both are directly related to the surgical procedure and are the threat for nearly every cancer patient. The second time for a risk of a poor, more cancer-specific outcome is due to improper staging and/or therapy. This outcome is traditionally expressed in disease-free survival and overall survival, but other outcome parameters such as good cosmetics, functional recovery and health-related quality of life 1 are also important parameters which can all vary widely because of the quality of the surgical procedure. In striving for the highest standard of quality in cancer care the cancer surgeon plays an essential role and is the most important prognostic factor twice in this whole process 2 .
