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Updated: May 20, 2026
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Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer
Published on: October 31, 2025
Aggressive surgical palliation for advanced girdle tumours
Andrew Burd1, K C Wong, Shekhar M Kumta
1Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong.
Summary
Surgical palliation for advanced cancer offers benefits but carries risks. Careful patient selection is crucial to avoid futile interventions and ensure improved quality of end-of-life care.
Area of Science:
- Oncology
- Surgical Oncology
- Palliative Care
Background:
- Advanced incurable malignant disease presents significant ethical and technical challenges in surgical management.
- The primary goal is palliation, with a critical need to avoid surgical futility.
- This case series addresses specific challenges encountered in end-of-life surgery.
Purpose of the Study:
- To explore the challenges and outcomes of surgical palliation in patients with advanced, incurable malignant disease.
- To evaluate the potential benefits and risks of aggressive surgical intervention at the end of life.
Main Methods:
- A review of fifteen patients with advanced malignant disease involving a limb girdle.
- Analysis of surgical interventions, patient outcomes, and palliative care effectiveness.
Main Results:
- One patient experienced a negative outcome due to delayed surgery, illustrating unrecognized futility.
- The remaining 14 patients achieved positive palliation, with improved quality of dying.
- Appreciation for palliative care was expressed by patients, relatives, and healthcare staff.
Conclusions:
- Selected patients with advanced malignant disease can benefit from aggressive surgical palliation by experienced teams.
- A narrow margin exists between successful palliation and futile intervention in end-of-life surgery.
- The challenges of end-of-life surgery necessitate careful consideration and skilled execution.
