Surgical palliation at a cancer center: Incidence and outcomes

Robert S. Krouse, Rebecca A. Nelson, Betty R. Farrell, Baiba Grube, Gloria Juarez, Lawrence D. Wagman, David Z.J. Chu

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Abstract

Hypothesis: Surgical intervention in palliative care is common; however, the indications, risks, and outcomes are not well described. Design: Retrospective review of surgical cases during a 1-year period with a minimum 1-year survival update. Setting: A National Cancer Institute-designated comprehensive cancer center. Patients: Patients with a cancer diagnosis undergoing operative procedures. Main Outcome Measures: Number of palliative surgeries and analysis of length of stay, morbidity, and mortality. Results: Palliative surgeries comprised 240 (12.5%) of 1915 surgical procedures. There were 170 major and 70 minor procedures. Neurosurgical (46.0%), orthopedic (31.3%), and thoracic (21.5%) surgical procedures were frequently palliative. The most common primary diagnoses were lung, colorectal, breast, and prostate cancers. Length of hospital stay was 12.4 days (range, 0-99 days), with 21.3% of procedures performed on an outpatient basis. The 30-day mortality was 12.2%, with 5 patients dying within 5 days of their procedure. The overall mortality was 23.3% (56/240). Mortality for surgical procedures classified as major was 21.9% (44/170) and 10.0% (7/70) for those classified as minor (Fisher exact test, P<.01). Conclusions: Significant numbers of palliative procedures are performed at our cancer center. Overall morbidity and mortality were high; however, a significant number of patients had short hospital stays and low morbidity. Palliative surgery should remain an important part of end-of-life care. Patients and their families must be aware of the high risks and understand the clear objectives of these procedures.

Original languageEnglish (US)
Pages (from-to)773-778
Number of pages6
JournalArchives of Surgery
Volume136
Issue number7
DOIs
StatePublished - Jan 1 2001

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ASJC Scopus subject areas

  • Surgery

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Krouse, R. S., Nelson, R. A., Farrell, B. R., Grube, B., Juarez, G., Wagman, L. D., & Chu, D. Z. J. (2001). Surgical palliation at a cancer center: Incidence and outcomes. Archives of Surgery, 136(7), 773-778. https://doi.org/10.1001/archsurg.136.7.773