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Decision making on surgical palliation based on patient outcome data
T J Miner1, D P Jaques, H Tavaf-Motamen
1General Surgery Service, Walter Reed Army Medical Center, Washington, DC 20307, USA.
American Journal of Surgery
|April 16, 1999
Summary
Effective surgical palliative care strategies lack standardization. Patient outcomes like pain control and quality of life are underreported in current literature, hindering informed decision-making for palliative procedures.
Area of Science:
- Oncology
- Surgical Palliative Care
Background:
- Palliative procedure application strategies are not standardized.
- Understanding of surgical palliative care is incomplete.
- Patient outcomes should guide decisions in surgical palliative care.
Purpose of the Study:
- To review the literature on surgical palliation of cancer.
- To assess the reporting of parameters crucial for effective palliative care.
Main Methods:
- MEDLINE search for articles published 1990-1996.
- Review of identified articles on surgical palliation of cancer.
- Analysis of designated parameters important for palliative care.
Main Results:
- 348 citations were reviewed.
- Reporting varied significantly for key elements: cost (2%), pain control (12%), quality of life (17%), intervention repetition (59%), morbidity/mortality (61%), survival (64%), physiologic response (69%).
- Standardized methods for quality of life and pain assessment were rarely used.
Conclusions:
- Current surgical literature rarely reports comprehensive data for informed palliative surgical choices.
- There is a need for improved reporting standards in palliative surgical care.
- Better data is required to guide effective palliative surgical interventions.