Decisions made by the multidisciplinary oncology team (MOT) should consider multiple aspects such as the health status of individual patients, the availability of local facilities and expertise . During a traditional MOT visit for solid organ tumors, one of the most important decisions to be made is whether or not to operate (in combination with adjuvant therapies) and, if surgery is not an option, to direct the patient towards alternative therapies. therapies, palliative care or follow-up. The choice to operate on a cancer patient entails the possibility that patients will experience complications related to the operation. On the other hand, an inappropriate “wait and see” policy could lead to the tumor progressing to an inoperable stage or result in the need for much more mutilating surgical procedures. The proposed diagram can help medical professionals make appropriate treatment decisions; in case of a non-optimal therapeutic cascade, referral to specialized centers should be suggested. The importance of a multidisciplinary approach to cancer treatment is one of the cornerstones of modern medicine. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay Furthermore, despite the progressive and important innovations that have been made regarding radiochemotherapies, surgery remains one of the crucial aspects of solid organ surgery. tumor management. Today, a multidisciplinary oncology team (MOT) should include both a dedicated oncologist and a surgeon with great experience in the specific field (e.g., liver, pancreatic, upper gastrointestinal, colorectal, urological, and female cancers). Many other medical and paramedical professionals are needed, depending on the organ affected and individual situations (e.g. radiologists, endocrinologists for thyroid cancer, anesthetists for pain management or palliative care, nurses for home care and administration of medications) to provide the best possible care. However, during a traditional MOT visit for solid organ tumors, one of the most important decisions to be made is whether or not to operate (in combination with adjuvant therapies) and, if surgery is not an option, to refer the patient to alternative therapies or palliative care. In cases of cases with equivocal outcomes, the MOT should also make decisions regarding the monitoring of a suspicious lesion, as well as the need for further imaging, further invasive investigations, or exploratory surgery. A standardized written or computer-generated form should be printed and signed by all participants. Furthermore, the choice to operate on an oncological patient, either with curative intent or to limit the progression of a preneoplastic lesion, entails the possibility that patients may encounter complications related to the operation. Perioperative complications can arise from a broad and heterogeneous spectrum of diseases, ranging from death to minor wound infections. However, many of these complications can be life-threatening or at least cause 3 prolonged hospital stays, thus reducing the amount of healthy time between relapses or delay the start of adjuvant therapies and ultimately reduce the chances of survival . On the other hand, an inappropriate “wait and see” policy could lead to the tumor progressing to an inoperable stage or result in the need for much more mutilating surgical procedures. Interestingly, there are many obvious and relevant issues between different types of operations, including the different biological behavior of each neoplasm and its natural history. Forbest understand and identify these challenging issues, balancing the pros and cons of an MOT decision, a simple plot a system was devised in which reported 30-day perioperative mortality was compared to the 5-year survival rate of a tumor serious damage to solid organs, according to numerous published data [3,4]. The so-called “MOT Challenge” diagram can also be divided into four quadrants: top left (A: low perioperative mortality/high survival), top right (B: high perioperative mortality/high survival), bottom right ( C: high perioperative mortality/low survival) and bottom left (D: low perioperative mortality/low survival), presented clockwise. This simple scheme has the advantage of being intuitive to use and easy to memorize; however, it is based on several assumptions. First, the source data is not unique and may differ globally, reflecting, for example, the outcomes of a given healthcare system with free access and a medium/high level of resources. Second, the 30-day mortality parameter may not take into account the risks of surgery avoiding many problems, such as hospital admissions and mortality rates, and the development of mutilating complications (e.g. unexpected stoma formation, persistent cardiopulmonary failure, impaired sexual intercourse, incontinence or voice changes). Third, the determination of surgical procedures may be very different with respect to the stage of disease in each organ (e.g., simple skin excision for an early melanoma or breast cancer versus extensive removal of tissue with plastic reconstruction 4 and lymphadenectomy). Finally, all reported perioperative mortality does not consider the excellence achieved in subspecialized centers, where complex surgeries should be performed. The most difficult implications for the MOT Challenge diagram fall in the “C” quadrant, where the majority of lethal solid organ tumors can be found. For example, pancreatic cancer presents a potentially dramatic impact on any MOT decision. An incidental lesion of the pancreatic head may be suspected to be an intraductal papillary mucinous neoplasm (IPNM) with “concerning features,” as seen with imaging, in a healthy patient eligible for surgery. Furthermore, it may be considered advisable to perform a formal pancreaticoduodenectomy (PD). This decision involves a balance between a reported perioperative mortality greater than 9% and a survival probability greater than 80% in the absence of an invasive component. However, this survival rate is expected to drop to less than half in years of a wait-and-see approach if invasive pancreatic cancer (rather than IPMN) is subsequently diagnosed. It may seem obvious that the high mortality rate after PD should consider the entire spectrum of these surgical patients, although the mortality rate is expected to be lower in the subgroup of otherwise healthy people incidentally diagnosed with IPMN. However, the possibility of non-life-threatening perioperative complications (e.g. postoperative fistula formation) and prolonged hospital stays should be considered. On the contrary, a differentiated thyroid cancer (the most frequent type) definitively falls into quadrant “A”. Furthermore, total thyroidectomy carries a negligible risk of perioperative mortality, even in frail patients, and the most serious complication is represented by the rare and often reversible lesion of the laryngeal nerve. In contrast, a borderline/indeterminate thyroid nodule carries a low risk of being malignant, and a “malignant” nodule presents at.