A prospective evaluation of palliative outcomes for surgery of advanced XXXX .

@entity5 @entity1 @entity204
BACKGROUND: We prospectively evaluated the effectiveness of major surgery in treating symptoms of advanced @entity5 . METHODS: Fifty-nine @entity1 were evaluated for major symptoms of intent to treat and were followed up until @entity204 or last clinical evaluation. Surgeons identified planned operations before surgery as either curative or palliative and estimated @entity1 survival time. An independent observer assessed symptom relief. A palliative surgery outcome score was determined for each symptomatic @entity1 . RESULTS: Surgeons identified 22 operations (37%) as palliative intent and 37 (63%) as curative intent. The median overall survival time was 14.9 months and did not differ between curative and palliative operations. Surgical morbidity was high but did not differ between palliative (41%) and curative (44%) operations. Thirty-three @entity1 (56%) were symptomatic before surgery, and major symptom resolution was achieved after surgery in 26 (79%) of 33. Good to excellent palliation, defined as a palliative surgery outcome score >70, was achieved in 64% of symptomatic @entity1 . CONCLUSIONS: Most symptomatic @entity1 with advanced @entity5 undergoing major operations attained good to excellent symptom relief. Outcome measurements other than survival are feasible and can better define the role of surgery in multimodality palliative care. A new outcome measure to evaluate major palliative operations is proposed.
