IN THE continuing program of the American College of Surgeons to raise the standards of surgical care, much rewarding effort has been expended on the problem of reducing to a minimum unnecessary surgery. One method among others has been the formation in each hospital of a Tissue Committee, whose function it is to scrutinize all surgical specimens in order to estimate the extent, if any, of unnecessary surgery. These Tissue Committees could also use the same material to study the problem of inadequate surgery.
Adequate surgery is, of course, particularly essential in many kinds of cancer in order to give the patients their best chance for survival. In certain fields there are honest and justifiable differences of opinion as to what would constitute adequate surgery, particularly in terms of the recent trend toward more radical procedures. On the other hand, in many cases there is well-established evidence to support readily