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Indications and use of palliative surgery-results of society of surgical oncology survey

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Abstract

Background: Despite increasing attention to end-of-life care in oncology, palliative surgery (PS) remains poorly defined. A survey to test the definition, assess the extent of use, and evaluate attitudes and goals of surgeons regarding PS was devised.

Methods: A survey of Society of Surgical Oncology (SSO) members.

Results: 419 SSO members completed a 110-item survey. Surgeons estimated 21% of their cancer surgeries as palliative in nature. Forty-three percent of respondents felt PS was best defined based on pre-operative intent, 27% based on post-operative factors, and 30% on patient prognosis. Only 43% considered estimated patient survival time an important factor in defining PS, and 22% considered 5-year survival rate important. The vast majority (95%) considered tumor still evident following surgery in a patient with poor prognosis constituted PS. Most surgeons felt PS could be procedures due to generalized illness related to cancer (80%) or related to cancer treatment complications (76%). Patient symptom relief and pain relief were identified as the two most important goals in PS, with increased survival the least important.

Conclusion: PS is a major portion of surgical oncology practice. Quality-of-life parameters, not patient survival, were identified as the most important goals of PS.

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Authors and Affiliations

  1. From the Department of General Oncologic Surgery, City of Hope National Medical Center, Duarte, California

    Laurence E. McCahill MD, David Chu MD & Lawrence D. Wagman MD

  2. Department of Nursing Research, City of Hope National Medical Center, Duarte, California

    Gloria Juarez RN, MSN & Betty Ferrell RN, PhD

  3. Department of Surgery, Southern Arizona Veteran’s Affairs Health Care System, Tucson, Arizona

    Robert Krouse MD

  4. Vital Research, Los Angeles, California

    Gwen C. Uman RN, PhD

Authors
  1. Laurence E. McCahill MD
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  2. Robert Krouse MD
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  3. David Chu MD
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  4. Gloria Juarez RN, MSN
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  5. Gwen C. Uman RN, PhD
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  6. Betty Ferrell RN, PhD
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  7. Lawrence D. Wagman MD
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Correspondence to Laurence E. McCahill MD.

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McCahill, L.E., Krouse, R., Chu, D. et al. Indications and use of palliative surgery-results of society of surgical oncology survey. Ann Surg Oncol 9, 104–112 (2002). https://doi.org/10.1245/aso.2002.9.1.104

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  • DOI: https://doi.org/10.1245/aso.2002.9.1.104

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