Alessandro Gronchi, Giorgio Bogani, Roberto Agresti, Riccardo A Audisio, Paolo Beretta, Alberto Biondi, Luca Bocciolone, Luigi Boni, Federico Cabitza, Dario Callegaro, Ferdinando Cm Cananzi, Marco Carnelli, Paolo G Casali, Jvan Casarin, Isabella Castiglioni, Federico Coccolini, Umberto Cortinovis, Francesco E D'Amico, Filippo De Braud, Giovanni De Manzoni, Alberto Deganello, Angelo Dei Tos, Paolo Delrio, Marcello Deraco, Massimo Falconi, Marco Ferrari, Caterina Foppa, Antonio Galfano, Viviana Galimberti, Laura Gangeri, Alfredo Garofalo, Massimiliano Gennaro, Aldo B Giannì, Leone Giordano, Gian Luca Grazi, Luigina Graziosi, Roberta Gunelli, Marco Guzzo, Fabiola Incandela, Germana Lissidini, Giulio Mari, Pietro Mascagni, Andrea Maurichi, Vincenzo Mazzaferro, Rosalba Miceli, Maria Teresa Montella, Isacco Montroni, Gennaro Musi, Sebastiano Nazzani, Alessandro Pardolesi, Roberto Patuzzo, Corrado Pedrazzani, Antonio Pellegrino, Elisabetta Pennacchioli, Arcangelo Picciariello, Vittorio Rampinelli, Francesco Raspagliesi, Marco Rastrelli, Sabino Russo, Roberto Salvia, Antonio Sommariva, Antonino Spinelli, Gaya Spolverato, Carlo Sposito, Manuela Tamburo De Bella, Guido Torzilli, Annalisa Trama, Giampaolo Ugolini, Emanuele Urso, Virginia Varca, Vanna Zanagnolo, Piergiorgio Solli, Nicola Nicolai, Collaborative for Research and Innovation in Surgical Oncology
Surgical innovation and oncologic practice are evolving rapidly. However, the evidence base supporting many interventions/decisions in surgical oncology remains vulnerable to bias, limited generalizability, and inconsistent reporting. To address this gap, this multidisciplinary review, developed through structured discussions among surgeons, methodologists, and data governance experts, proposes methodological principles to support the generation of credible, patient-relevant, and decision-oriented evidence in surgical oncology. The proposed framework emphasizes clinically actionable research questions, study designs proportionate to surgical realities, transparent comparator strategies, rigorous data governance, and communication aligned with guideline and policy decision-making. The paper also discusses the responsible integration of artificial intelligence (AI)-enabled methodologies and the opportunities created by the secondary use of health data within the European Health Data Space (EHDS). High-quality surgical oncology research requires methodological rigor, data integrity, and dissemination to be treated as integral components of clinical excellence.