Improving the value of palliative surgery by optimizing patient selection: The role of long-term survival on high impact palliative intent operations
In order to better characterize outcomes of palliative surgery (PS), we evaluated patients that experienced top quartile survival to elucidate predictors of high impact PS. All PS performed on advanced cancer patients from 2003 to 2017 were identified from a PS database. 167 patients were identified...
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| Veröffentlicht in: | The American journal of surgery 2021-05, Vol.221 (5), p.1018-1023 |
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| container_title | The American journal of surgery |
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| creator | Cohen, Joshua T Fallon, Eleanor A Charpentier, Kevin P Cioffi, William G Miner, Thomas J |
| description | In order to better characterize outcomes of palliative surgery (PS), we evaluated patients that experienced top quartile survival to elucidate predictors of high impact PS.
All PS performed on advanced cancer patients from 2003 to 2017 were identified from a PS database.
167 patients were identified. Multivariate analysis demonstrated the ability to rise from a chair was independently associated with top quartile survival (HR 7.61, 95% CI 2.12-48.82, p=0.008) as was the need for re-operation (HR 2.81, 95% CI 1.26-6.30, p=0.0012). Patients who were able to rise from a chair had significantly prolonged overall survival (320 vs 87 days, p |
| doi_str_mv | 10.1016/j.amjsurg.2020.08.034 |
| format | Article |
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All PS performed on advanced cancer patients from 2003 to 2017 were identified from a PS database.
167 patients were identified. Multivariate analysis demonstrated the ability to rise from a chair was independently associated with top quartile survival (HR 7.61, 95% CI 2.12-48.82, p=0.008) as was the need for re-operation (HR 2.81, 95% CI 1.26-6.30, p=0.0012). Patients who were able to rise from a chair had significantly prolonged overall survival (320 vs 87 days, p < 0.001).
Although not the primary goal, long-term survival can be achieved following PS and is associated with re-operation and the ability to rise from a chair. These patients experience the benefits of PS for a longer period of time, which in turn maximizes value and positive impact.
Long-term survival and symptom control can be achieved in highly selected advanced cancer patients following palliative surgery. The ability of the patient to independently rise from a chair and the provider to offer a re-operation when indicated are associated with long-term survival following a palliative operation.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2020.08.034</identifier><identifier>PMID: 32980077</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Cancer ; Cancer therapies ; Laboratories ; Medical records ; Multivariate analysis ; Palliation ; Palliative care ; Patients ; Quality of life ; Success ; Surgeons ; Surgery ; Survival</subject><ispartof>The American journal of surgery, 2021-05, Vol.221 (5), p.1018-1023</ispartof><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32980077$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cohen, Joshua T</creatorcontrib><creatorcontrib>Fallon, Eleanor A</creatorcontrib><creatorcontrib>Charpentier, Kevin P</creatorcontrib><creatorcontrib>Cioffi, William G</creatorcontrib><creatorcontrib>Miner, Thomas J</creatorcontrib><title>Improving the value of palliative surgery by optimizing patient selection: The role of long-term survival on high impact palliative intent operations</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>In order to better characterize outcomes of palliative surgery (PS), we evaluated patients that experienced top quartile survival to elucidate predictors of high impact PS.
All PS performed on advanced cancer patients from 2003 to 2017 were identified from a PS database.
167 patients were identified. Multivariate analysis demonstrated the ability to rise from a chair was independently associated with top quartile survival (HR 7.61, 95% CI 2.12-48.82, p=0.008) as was the need for re-operation (HR 2.81, 95% CI 1.26-6.30, p=0.0012). Patients who were able to rise from a chair had significantly prolonged overall survival (320 vs 87 days, p < 0.001).
Although not the primary goal, long-term survival can be achieved following PS and is associated with re-operation and the ability to rise from a chair. These patients experience the benefits of PS for a longer period of time, which in turn maximizes value and positive impact.
Long-term survival and symptom control can be achieved in highly selected advanced cancer patients following palliative surgery. The ability of the patient to independently rise from a chair and the provider to offer a re-operation when indicated are associated with long-term survival following a palliative operation.</description><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Laboratories</subject><subject>Medical records</subject><subject>Multivariate analysis</subject><subject>Palliation</subject><subject>Palliative care</subject><subject>Patients</subject><subject>Quality of life</subject><subject>Success</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Survival</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdkMtq5DAQRcWQYdLpySckCLLJxh49bFnOLoS8IDCbnrWR1aVuNbLlSHJD5z_yv2PnASGroqhzTxWF0BklOSVU_NnlqtvFMWxyRhjJicwJL36gBZVVnVEp-RFaEEJYVgtKjtFJjLuppbTgv9AxZ7UkpKoW6PWxG4Lf236D0xbwXrkRsDd4UM5Zlewe8LwEwgG3B-yHZDv7MtPDNIQ-4QgOdLK-v8KrSRC8e8s732-yBKGb43s7ebHv8dZutth2g9Lp6wbbp1nlBwhqVsXf6KdRLsLpR12if3e3q5uH7Onv_ePN9VM2MF6nrDSCA1FrU_FKyEqYoqWFIq0uTFW3oI3Ra2GYLrWRGoxhvOVrYiomoFUgKF-iy3fv9IPnEWJqOhs1OKd68GNsWFGIWsqSygm9-Ibu_Bj66bqGlYwWspSSTNT5BzW2HaybIdhOhUPz-XD-H6GViYM</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>Cohen, Joshua T</creator><creator>Fallon, Eleanor A</creator><creator>Charpentier, Kevin P</creator><creator>Cioffi, William G</creator><creator>Miner, Thomas J</creator><general>Elsevier Limited</general><scope>NPM</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>202105</creationdate><title>Improving the value of palliative surgery by optimizing patient selection: The role of long-term survival on high impact palliative intent operations</title><author>Cohen, Joshua T ; Fallon, Eleanor A ; Charpentier, Kevin P ; Cioffi, William G ; Miner, Thomas J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p239t-5f63e0adf7376876f4b14a0bc4f79becffcd6f2c5cf8ceff23b3d0f726ebae613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Laboratories</topic><topic>Medical records</topic><topic>Multivariate analysis</topic><topic>Palliation</topic><topic>Palliative care</topic><topic>Patients</topic><topic>Quality of life</topic><topic>Success</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cohen, Joshua T</creatorcontrib><creatorcontrib>Fallon, Eleanor A</creatorcontrib><creatorcontrib>Charpentier, Kevin P</creatorcontrib><creatorcontrib>Cioffi, William G</creatorcontrib><creatorcontrib>Miner, Thomas J</creatorcontrib><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cohen, Joshua T</au><au>Fallon, Eleanor A</au><au>Charpentier, Kevin P</au><au>Cioffi, William G</au><au>Miner, Thomas J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improving the value of palliative surgery by optimizing patient selection: The role of long-term survival on high impact palliative intent operations</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2021-05</date><risdate>2021</risdate><volume>221</volume><issue>5</issue><spage>1018</spage><epage>1023</epage><pages>1018-1023</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>In order to better characterize outcomes of palliative surgery (PS), we evaluated patients that experienced top quartile survival to elucidate predictors of high impact PS.
All PS performed on advanced cancer patients from 2003 to 2017 were identified from a PS database.
167 patients were identified. Multivariate analysis demonstrated the ability to rise from a chair was independently associated with top quartile survival (HR 7.61, 95% CI 2.12-48.82, p=0.008) as was the need for re-operation (HR 2.81, 95% CI 1.26-6.30, p=0.0012). Patients who were able to rise from a chair had significantly prolonged overall survival (320 vs 87 days, p < 0.001).
Although not the primary goal, long-term survival can be achieved following PS and is associated with re-operation and the ability to rise from a chair. These patients experience the benefits of PS for a longer period of time, which in turn maximizes value and positive impact.
Long-term survival and symptom control can be achieved in highly selected advanced cancer patients following palliative surgery. The ability of the patient to independently rise from a chair and the provider to offer a re-operation when indicated are associated with long-term survival following a palliative operation.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>32980077</pmid><doi>10.1016/j.amjsurg.2020.08.034</doi><tpages>6</tpages></addata></record> |
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| subjects | Cancer Cancer therapies Laboratories Medical records Multivariate analysis Palliation Palliative care Patients Quality of life Success Surgeons Surgery Survival |
| title | Improving the value of palliative surgery by optimizing patient selection: The role of long-term survival on high impact palliative intent operations |
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