Surgical palliation at a cancer center: incidence and outcomes.
Arch Surg
; 136(7): 773-8, 2001 Jul.
Article
en En
| MEDLINE
| ID: mdl-11448388
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 OUTCOMEMEASURES:
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.
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Banco de datos:
MEDLINE
Asunto principal:
Cuidados Paliativos
/
Neoplasias
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Surg
Año:
2001
Tipo del documento:
Article
País de afiliación:
Estados Unidos