Building an integrated multidisciplinary care system for emergency surgery in abdominal cancer: a patient-centered...

Abdominal oncologic emergencies demand urgent surgical decisions that may conflict with ongoing cancer therapies and patient preferences. Conventional fragmented care models often lead to delays, inconsistent decisions, and poor care transitions. To address this gap, this perspective article proposes an integrated, patient-centered care model structured in three stages: rapid initial assessment, a structured emergency multidisciplinary team meeting, and coordinated care with seamless transitions. Central to this framework is a structured decision-making guide for emergency surgery that comprehensively integrates patient factors (health status, prognosis), tumor-related factors (emergency severity, technical feasibility), and patient preferences and context. Based on this triad, clinicians can pursue one of three clear pathways: immediate stabilization, definitive emergency oncologic surgery for suitable candidates, or prioritized non-operative or palliative-first approach when surgery offers limited benefit. Supported by innovations like standardized pathways and emergency-specific performance metrics, this framework aims to enhance safety, timely goal-concordant care, and resource efficiency in abdominal cancer emergency surgery.