Indications and use of palliative surgery-results of Society of Surgical Oncology survey.
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.


CONCLUSIONS
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.
McCahill
Laurence E
LE
Department of General Oncologic Surgery, City of Hope National Medical Center, Duarte, California 91010, USA. lmccahill@coh.org
Krouse
Robert
R
Chu
David
D
Juarez
Gloria
G
Uman
Gwen C
GC
Ferrell
Betty
B
Wagman
Lawrence D
LD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000592:standards*; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D010166:Palliative Care / Q000592:standards*; D011364:Professional Practice / Q000592:standards; D011788:Quality of Life; D012955:Societies, Medical / Q000592:standards*