A broad knowledge is needed to plan optimal treatment for an individual cancer patient throughout the disease course. The trainee in surgical oncology must therefore have a knowledge of fundamental biology of cancer including etiology and epidemiology, natural history of malignant diseases, cancer biology as well as tumour immunology.

3.1. Etiology and epidemiology of malignant diseases

• environmental factors in carcinogenesis
• genetic factors in carcinogenesis
• evaluate the risk and risk factors for malignant diseases
• terminology in epidemiology

3.2. Prognosis and natural history of malignant diseases

• mechanisms and patterns in local, regional and distant dissemination of malignant diseases
• differences in natural history between hereditary and sporadic forms of cancer
• diseases predisposing to malignancy e.g. inflammatory bowel disease or primary sclerosing cholangitis
• prognostic and predictive factors
• genetics of hereditary malignant diseases

3.3. Cancer biology

• cell kinetics, proliferation, apoptosis and the balance between cell death and cell proliferation
• angiogenesis and lymphangiogenesis
• genome maintenance mechanisms to prevent cancer
• intercellular and intermolecular adhesion mechanisms and signalling pathways
• potential effects of surgery and surgery-related events on cancer biology (e.g. angioenesis)
  

3.4. Tumour immunology

• cellular and humoral components of the immune system
• regulatory mechanisms of the immune system
• tumour antigeneity
• immune-mediated antitumour cytotoxicity
• effect of cytokines on the tumour
• effects of the tumour on anti-tumour immune mechanisms
• potential adverse effects of surgery and surgery-related events (like blood transfusions) on the immunological responses
   

3.5. Basic principles of cancer treatment

A trainee in surgical oncology has to become familiar with the basic principles of

• surgery
• radiotherapy
• chemotherapy
• endocrine therapy
• immunotherapy
• evaluation of the choices of treatments
• adverse effects with these treatments
• interactions of these treatment modalities with those of surgery
  

3.6. Clinical studies and evidence based medicine

A trainee in surgical oncology must achieve a broad knowledge regarding cancer research to be able to evaluate the results of published clinical studies, to conduct a clinical study and to facilitate translational research. It is also essential to understand the principles and the pitfalls of evidence based medicine.

 3.6.1. Evaluate published clinical studies

• relevance of statistical methods
• inclusion or exclusion criteria of the study objects
• the power of the study
• intention to treat
• number needed to treat
• relative and absolute benefit
• distinguish between statistical and clinical significance
  

3.6.2. Conduct clinical studies

• design and implement a prospective database
• elementary principles in biostatistics and the most commonly used statistical analyses
• ethics and legal aspects in research.

A trainee in surgical oncology should prepare at least one scientific paper during the training period. It could be either an original research article, a structured review or a meta-analysis. A case-report is not sufficient.