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From the Department of General Oncologic Surgery (LEM, DC, LW) and Department of Nursing Research (GJ, BF), City of Hope National Medical Center, Duarte, California; Department of Surgery (RK,), Southern Arizona Veteran’s Affairs Health Care System, Tucson, Arizona; Vital Research (GCU), Los Angeles, California.
Correspondence: Address correspondence to: Laurence McCahill, MD, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010; Fax: 626-359-8941; E-mail: lmccahill{at}coh.org
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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