|Although surgery often is intended to be curative, it may sometimes be used to assuage pain or dysfunction. This type of surgery, called palliative surgery, can remove an intestinal obstruction or remove masses that are causing pain or disfigurement. Palliative surgery is typically defined as any procedure performed to reduce symptoms or improve quality of life in a patient with an advanced malignancy, excluding operations for potential cure. Increasingly, health care systems are requiring quality standards to be analyzed in order to justify surgical interventions. One contemporary movement that has drive hospitals to address issues of safety, quality, and affordability is The Leapfrog Group. The three original âleapsâ in quality included computerized prescriber order entry, intensive care unit (ICU) physician staffing, and evidence-based hospital referral. A 2008 update on improvements resulting from the adoption of Leapfrog safety and quality standards showed that adoption of all three leaps at an urban hospital could save a total of 12.04 billion dollars and 57,903 lives per year. As surgical palliation becomes an increasingly larger component of comprehensive cancer care, the same standards of excellence will need to be set by evidence-based studies. Establishing this foundation is crucial for ensuring patient safety, optimizing quality of care, setting expectations for families, aiding surgeons in complicated clinical decisions, and supporting the use of healthcare resources.