Essential Knowledge and Skills for the Practice of Pediatric Surgical Oncology A Modified Delphi Consensus Study by the APSA Cancer Committee

Infographic · Jan 2026 · 1 min read

In brief

APSA Cancer Committee achieved consensus on 177 essential knowledge and skill statements for surgeons caring for children with cancer through a modified Delphi study with 35 experts. Key findings emphasize multidisciplinary team approaches and tumor-specific management principles to guide appropriate surgeon-patient matching without creating access barriers.

177 consensus statements defined essential knowledge/skills for pediatric surgical oncologists across 8 domains including solid tumors and resources
Multidisciplinary care is critical—complex resections require multidisciplinary surgical teams and tumor-specific management knowledge
Exclusive pediatric surgical oncology practice is not feasible for most surgeons, necessitating consensus on minimum competencies
Expert panel of 35 panelists from 24 institutions achieved excellent internal consistency (Cronbach's alpha >0.98) across 3 Delphi rounds
Consensus aims to match children with appropriately skilled surgeons while minimizing barriers to care access for families

Written by the GCMD Library team from the infographic.

The infographic uses a teal header, purple middle section with white text boxes, and yellow footer. Cartoon illustrations include three panelists on the left, a hospital building icon on the right, and a surgeon with clipboard and surgical instruments. The layout presents key findings in a hierarchical flow from study details to conclusions.

Elisabeth T Tracy , Abigail Engwall , Erin G Brown , Raphael C Sun , Ashley Walther, Catherine B Beckhorn, Dave Lal, David H Rothstein, Jonathan Roach, Nicholas Cost , Barrie S Rich , Peter F Ehrlich , Jennifer H Aldrink , David Rodeberg; KidsCancerSurgery Research Group

Purpose: Childhood cancer care has become increasingly complex. However, the exclusive practice of pediatric surgical oncology is not feasible for most surgeons taking care of these children. Thus, the American Pediatric Surgical Association (APSA) Cancer Committee conducted a modified Delphi study to reach a national consensus on the essential knowledge, skills, and institutional setting for surgeons caring for children with cancer.

Methods: After development of candidate statements, the APSA Cancer Committee conducted a modified Delphi process consisting of two classic rounds and a third consensus round. Statements were reviewed by an expert panel consisting of pediatric surgical oncologists, pediatric medical oncologists, pediatric surgery program directors, general pediatric, recent pediatric surgery graduates. Consensus was defined a priori as Cronbach's alpha > 0.8 and greater than 80% panel agreement.

Results: Initial candidate statements comprised eight domains including solid tumors, metastasis, and institution resources. After review by the expert panel consisting of 35 panelists from 24 institutions across 18 US states and Canada, 177 statements achieved consensus. Internal consistency was excellent (Cronbach's alpha 0.989, 0.987, and 0.987 after rounds 1-3). A major emphasis of the consensus statements was on the importance of multidisciplinary care, including multidisciplinary surgical teams for complex resections, and knowledge of current tumor-specific management principles.

Conclusions: This study represents the first national consensus study of the knowledge and skills essential for pediatric surgical oncology. These results should inform ongoing conversations about how best to match children with cancer to the surgeons equipped to care for them without creating additional barriers for families.

The text in the image

Essential Knowledge and Skills for the Practice of Pediatric Surgical Oncology | Modified Delphi consensus study | 2022-2023 | Expert panel | 35 panelists | 24 institutions | 18 US states & Canada | The first national consensus defining pediatric surgical oncology competencies | Complex resections should involve multidisciplinary teams: oncology, radiology, pathology, & anesthesia | Surgeons must understand tumor-specific management principles | Consensus was achieved on the knowledge, skills, and institutional capacities that are essential | Conclusion: This first national consensus defines essential pediatric surgical oncology skills to better match children with cancer to appropriately trained surgeons without added barriers. | https://pubmed.ncbi.nlm.nih.gov/40413321/ | Tracy ET et al. | Division of Pediatric Surgery, University of North Carolina at Chapel Hill, USA | @LizzyPAC8 | @globalcastmd | @StayCurrentMD | Cincinnati Children's