A prospective, symptom related, outcomes analysis of 1022 palliative procedures for advanced cancer

Annals of Surgery
Thomas J MinerDavid P Jaques

Abstract

To prospectively evaluate surgical procedures performed with palliative intent. There is a paucity of outcomes data necessary to allow sound surgical decision-making and informed consent for palliative procedures. Procedures to palliate symptoms of advanced cancer were identified prospectively from all operations performed. Patients were observed for >90 days or until death. There were 1022 palliative procedures performed in 823 patients from July 2002 to June 2003. Operative (713/1022) or endoscopic (309/1022) procedures were performed for gastrointestinal obstruction (34%), neurologic symptoms (23%), pain (12%), dyspnea (9%), jaundice (7%) or other symptoms (15%). Symptom improvement or resolution within 30 days was achieved in 80% (659/823). Median duration of symptom control was 135 days. Recurrence of the primary symptom occurred in 25% (165/659) while treatment of debilitating additional symptoms was required in 29% (191/659). Palliative procedures were associated with 30-day postoperative morbidity (29%) and mortality (11%). A major postoperative complication reduced the probability of symptom improvement to 17%. Median survival was 194 days from the time of the palliative procedure and was adversely associated with poor...Continue Reading

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Citations

Sep 21, 2016·World Journal of Gastrointestinal Surgery·Brittany A Potz, Thomas J Miner
Nov 7, 2018·World Journal of Gastrointestinal Surgery·Chelsey C CiambellaThomas J Miner
Mar 25, 2020·World Journal of Gastrointestinal Oncology·Peng-Ju ChenAi-Wen Wu
Feb 7, 2007·The British Journal of Surgery·S PalmaM Delgado-Rodríguez
Nov 25, 2020·The American Surgeon·Eleanor A Fallon, Thomas J Miner
Jun 1, 2021·Surgical Oncology Clinics of North America·Cassandra S Parker, Thomas J Miner
Jun 1, 2021·Surgical Oncology Clinics of North America·Caitlin T Yeo, Shaila J Merchant
Nov 10, 2015·Journal of Visceral Surgery·F DumontD Elias
Apr 9, 2005·Surgical Oncology Clinics of North America·Harold J WaneboKimberly A Varker
Apr 19, 2005·The Surgical Clinics of North America·Geoffrey P Dunn
Aug 3, 2005·American Journal of Clinical Oncology·Thomas J Miner
Feb 24, 2006·American Journal of Surgery·Yehuda KarivConor P Delaney
Oct 26, 2005·Annals of Surgical Oncology·Jen Jen YehDavid P Jaques
Dec 26, 2006·Journal of Palliative Medicine·Victor T ChangChi Chau
Mar 8, 2007·Annals of Surgical Oncology·Daniel D KlaristenfeldThomas J Miner
May 29, 2007·Journal of Pain and Symptom Management·Alice LaneaderDavid Casarett
Sep 21, 2007·Surgical Oncology·Steven C Cunningham, Richard D Schulick
Oct 5, 2007·Surgical Oncology·Nir Wasserberg, Howard S Kaufman
Oct 16, 2007·Surgical Oncology·Steven C CunninghamTimothy M Pawlik
Dec 1, 2007·The Indian Journal of Surgery·Nagarjuna V MaturuVishnu N R Prasad
Feb 27, 2008·World Journal of Gastroenterology : WJG·Varut LohsiriwatNarong Lert-Akayamanee
Mar 7, 2008·Current Treatment Options in Gastroenterology·Samielle Brancato, Thomas J Miner
Dec 17, 2008·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Brian D BadgwellJanice N Cormier
Dec 1, 2008·The Indian Journal of Surgery·Nagarjuna V MaturuVishnu N R Prasad
Feb 3, 2009·The Surgical Clinics of North America·Alan A ThomayThomas J Miner
Jun 17, 2009·Current Opinion in Supportive and Palliative Care·Velia A Löbbe
Sep 1, 2009·Pediatric Surgery International·Mindy Young-SpintVijay P Khatri
Feb 4, 2010·Journal of the American College of Surgeons·Satish NagulaHans Gerdes
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Jan 14, 2011·Advances in Therapy·Leandro Feo, David M Schaffzin
Mar 23, 2011·The Surgical Clinics of North America·Thomas J Miner

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