Patient reasoning in palliative surgical oncology.
BACKGROUND
The purpose of this study was to determine the patient reasoning behind treatment choice after palliative surgical consultation.


METHODS
Patients undergoing palliative surgical consultation were prospectively enrolled in this observational cohort study (11/2009-5/2011) and administered an open-ended questionnaire asking for their reasoning in choosing their treatment strategy.


RESULTS
Of 98 patients enrolled, 54 were treated non-operatively and 44 with surgery. Patient responses indicating their reason for treatment selection were categorized into (1) quality of life or symptom relief, (2) unclear or response not related to treatment strategy, (3) increase length of life, (4) treat the cancer, (5) concerns over surgical complications, (6) doctor's recommendation, (7) religious reasons for treatment choice, and (8) for family. The most frequently cited reason for treatment selection was symptom relief or quality of life improvement in 46 patients. Thirty-eight patients cited their doctor's recommendation while 20 patients selected their treatment to increase length of life or treat their cancer. Only 2 patients cited concerns over surgical complications as their reason for choosing their treatment strategy.


CONCLUSIONS
The most common reasons for treatment selection in palliative surgical consultation include symptom relief or improvement in quality of life and the doctor's recommendation with few patients listing concerns over surgical morbidity.
Department of Surgical Oncology, The University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Lindsey K
LK
Collins
Julia A
JA
Goodwin
Horace J
HJ
Spencer
Caesar
C
Guevara
Betty
B
Ferrell
Jean
J
McSweeney
Brian D
BD
Badgwell
D000368:Aged; D001131:Arkansas; D002755:Choice Behavior; D003657:Decision Making; D004522:Educational Status; D004651:Employment; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008136:Longevity; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D010166:Palliative Care / Q000379:methods / Q000523:psychology; D010361:Patients / Q000523:psychology*; D010819:Physician's Role; D011446:Prospective Studies; D011788:Quality of Life; D012017:Referral and Consultation; D012067:Religion; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D011795:Surveys and Questionnaires; D063189:Symptom Assessment; D016896:Treatment Outcome