Non-curative surgical oncology: postoperative needs and preferences

Area of Science:

• Oncology
• Palliative Care
• Qualitative Research

Background:

• Intended curative cancer surgery is often not completed for patients with peritoneal metastases.
• Approximately 25% of patients referred for specialized surgery for peritoneal metastases do not undergo the procedure.
• Patient needs and preferences following non-completion of intended surgery are poorly understood.

Purpose of the Study:

• To explore the postoperative needs and preferences of patients who did not undergo intended curative cancer surgery for peritoneal metastases.
• To understand the patient experience when a planned curative surgery is not performed.
• To identify key factors influencing patient well-being in this specific clinical scenario.

Main Methods:

• Conducted 14 qualitative research interviews with 12 patients (ovarian and colorectal cancer) undergoing surgery for peritoneal metastases.
• Interviews included five patients with a relative present.
• Data were analyzed using meaning condensation following a semistructured interview guide.

Main Results:

• Patients accepted the decision not to proceed with surgery.
• Patient needs rapidly evolved postoperatively, especially upon realizing prognostic consequences.
• Patients gradually reoriented their life focus, influenced by changes in treatment strategy and physical/psychosocial aspects.

Conclusions:

• Patient-centered communication is vital for psychosocial reorientation and quality of life when curative surgery is not completed.
• Patients require basic supportive care and physical restitution to enhance well-being and action competences.
• Coordinated, high-quality postoperative palliative care is essential, necessitating staff training and pathway reorganization.