Effect of Perioperative Palliative Care on Health-Related Quality of Life Among Patients Undergoing Surgery for Cancer

• DOI: 10.1001/jamanetworkopen.2023.14660
• Publication Date: 2023-05-31T15:33:17Z
• Authors: Rebecca A. Aslakson; Elizabeth Rickerson; Bridget Fahy; Brittany Waterman; Rachel Siden; Kathryn Colborn; Shelby Smith; Mae Verano; Isaac Lira; Caroline Hollahan; Amn Siddiqi; Kemba Johnson; Shivani Chandrash...; Elizabeth Harris; Richard Nudotor; Joshua Baker; Shireen N. Heidari; George Poultsides; Alison M. Conca-C...; Allyson Cook Chapman; Anna Sophia Lessios; Laura M. Holdsworth; Jillian Gustin; Aslam Ejaz; Timothy Pawlik; Judi Miller; Arden M. Morris; James A. Tulsky; Karl Lorenz; Jennifer S. Temel; Thomas J. Smith; Fabian Johnston
• Keywords: Male; Mental Health; Patients; Palliative Care; Quality of Life; Humans; Female; Middle Aged; 3. Good health; Original Investigation; Gastrointestinal Neoplasms

Importance Involvement of palliative care specialists in the medical oncology patients has been repeatedly observed to improve patient-reported outcomes, but there is no analogous research surgical populations. Objective To determine whether surgeon–palliative team comanagement, compared with surgeon alone management, improves perioperative outcomes among pursuing curative-intent surgery for high morbidity and mortality upper gastrointestinal (GI) cancers. Design, Setting, Participants From October 20, 2018, March 31, 2022, a patient-randomized clinical trial was conducted clinicians nonblinded analysis blinded allocation. The 5 geographically diverse academic centers US. Individuals an GI cancer who had received previous specialist were eligible. Surgeons encouraged offer participation all eligible patients. Intervention Surgeon–palliative comanagement met either person or via telephone before surgery, 1 week after 1, 2, 3 months surgery. For surgeon-alone group, surgeons follow National Comprehensive Cancer Network–recommended triggers consultation. Main Outcomes Measures primary outcome health-related quality life at following operation. Secondary mental physical distress. Intention-to-treat performed. Results In total, 359 (175 [48.7%] men; mean [SD] age, 64.6 [10.7] years) randomized (n = 177) 182), most (206 [57.4%]) undergoing pancreatic No adverse events associated intervention, 11% 90% groups There significant difference between study arms operation (mean [SD], 138.54 [28.28] vs 136.90 [28.96]; P .62), health −0.07 [0.87] [0.84]; .98), overall number deaths (6 [3.7%] 7 [4.1%]; > .99). Conclusions Relevance date, this first multisite evaluate earliest integration into care. Unlike practice, data from do not suggest care–associated improvements surgeries Trial Registration ClinicalTrials.gov Identifier: NCT03611309