Work

Impact of Early Palliative Care 6 Months After Major Abdominal Surgery for Cancer

Year: 2026

Type: article

Abstract: INTRODUCTION: The Surgery for Cancer with Option of Palliative Care Expert randomized clinical trial showed no evidence that a specialist palliative care intervention improved 90-d postoperative outcomes in patients undergoing surgery for cancer. Effects at 6 mo postoperatively have not been evaluated. METHODS: This was a prospective, single-center randomized clinical trial performed from 2019 to 2021. Patients undergoing nonpalliative surgery of an intra-abdominal malignancy were enrolled. The intervention group received usual care plus early specialist palliative care preoperatively and postoperatively. The prespecified secondary outcome was Post-traumatic stress disorder (PTSD) symptoms measured by the PTSD Checklist-Civilian Version 180 d postoperatively. Exploratory outcomes included post-traumatic growth, anxiety, depression, and life-space. RESULTS: In 235 included patients, PTSD symptoms did not differ significantly at 180 d postoperatively (intervention versus usual care adjusted odds ratio [OR], 1.16; 95% confidence interval, 0.70-1.93) nor did post-traumatic growth (OR, 0.96; 95% CI, 0.71-1.31). The intervention group had lower anxiety (OR, 0.59; 95% CI, 0.36-0.96) and depression (OR, 0.57; 95% CI 0.35-0.94) and larger life-space (OR, 1.69; 95% CI, 1.16-2.46). However, the differences in adjusted median scores for these exploratory outcomes were small and less than the minimal clinically important difference for these measures. CONCLUSIONS: This study found no difference in the prespecified secondary outcome and small differences of unclear clinical significance in three exploratory outcomes favoring early palliative referral among patients undergoing surgery for cancer. However these results should be interpreted cautiously and do not justify the routine deployment of scarce palliative care resources in the perioperative setting.

Source: Journal of Surgical Research

DOI: 10.1016/j.jss.2026.07.046

Authors: Peter A. Bryant, Onur M. Orun, Rameela Raman, Myrick C. Shinall

Institutions: Vanderbilt University, Vanderbilt University Medical Center, VA Tennessee Valley Healthcare System

Language: English

Topic: Palliative Care and End-of-Life Issues

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,590