REVIEW ARTICLE
Definition of Palliative Surgery in Cancer Care: A Systematic Review
Jolene Si Min Wong,
Xinyi Casuarine Low,
Orly N. Farber,
Jennifer W. Mack,
Zara Cooper,
Elizabeth J. Lilley,
Jolene Si Min Wong
Center for Surgery and Public Health, Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Sarcoma, Peritoneal & Rare Tumors, Division of Surgery and Surgical Oncology, National Cancer Center Singapore & Singapore General Hospital, Singapore City, Singapore
Search for more papers by this authorXinyi Casuarine Low
Department of Sarcoma, Peritoneal & Rare Tumors, Division of Surgery and Surgical Oncology, National Cancer Center Singapore & Singapore General Hospital, Singapore City, Singapore
Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore City, Singapore
Search for more papers by this authorOrly N. Farber
Center for Surgery and Public Health, Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorJennifer W. Mack
Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
Search for more papers by this authorZara Cooper
Center for Surgery and Public Health, Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorCorresponding Author
Elizabeth J. Lilley
Center for Surgery and Public Health, Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
Correspondence: Elizabeth J. Lilley ([email protected])
Search for more papers by this authorJolene Si Min Wong,
Xinyi Casuarine Low,
Orly N. Farber,
Jennifer W. Mack,
Zara Cooper,
Elizabeth J. Lilley,
Jolene Si Min Wong
Center for Surgery and Public Health, Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Sarcoma, Peritoneal & Rare Tumors, Division of Surgery and Surgical Oncology, National Cancer Center Singapore & Singapore General Hospital, Singapore City, Singapore
Search for more papers by this authorXinyi Casuarine Low
Department of Sarcoma, Peritoneal & Rare Tumors, Division of Surgery and Surgical Oncology, National Cancer Center Singapore & Singapore General Hospital, Singapore City, Singapore
Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore City, Singapore
Search for more papers by this authorOrly N. Farber
Center for Surgery and Public Health, Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorJennifer W. Mack
Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
Search for more papers by this authorZara Cooper
Center for Surgery and Public Health, Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorCorresponding Author
Elizabeth J. Lilley
Center for Surgery and Public Health, Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
Correspondence: Elizabeth J. Lilley ([email protected])
Search for more papers by this authorFirst published: 28 November 2024
Jolene Si Min Wong and Xinyi Casuarine Low contributed equally to this work.
[Correction added on 3 May 2025, after first online publication: The formatting of the first author's name has been corrected in this version.]
ABSTRACT
Palliative surgery is commonly performed in cancer centers worldwide. Yet, there is little agreement on the definition of palliative surgery or its relevant outcomes. This systematic review sought to characterize the definitions of palliative surgery and outcomes for patients with cancer undergoing thoraco-abdominal procedures. Following PRISMA guidelines, we conducted a search using PubMed, EMBASE and CINAHL databases to identify English-language publications between August 1, 2005, and December 31, 2023 reporting palliative thoraco-abdominal procedures for patients with cancer. Definitions of palliative surgery were coded and analyzed using an inductive approach. Outcomes were classified according to an outcome measures hierarchy. Among 92 articles met inclusion criteria and four themes emerged in how palliative surgery was defined throughout the literature: prognosis (incurable cancer diagnosis), purpose (intent to treat symptoms or improve quality of life), procedure type (specific operative interventions), or persistent disease following surgery (incomplete cytoreduction). Survival (90%) and perioperative complications/morbidity (72%) were the most commonly reported outcomes, whereas symptom relief, quality of life, and sustainability of success were infrequently reported. Definitions of palliative surgery vary across studies of patients with cancer undergoing thoracic or abdominal procedures and measured outcomes often do not align with the intent of surgery.
Open Research
Data Availability Statement
The authors have nothing to report.
Supporting Information
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Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- 1L. E. McCahill, D. D. Smith, T. Borneman, et al., “A Prospective Evaluation of Palliative Outcomes for Surgery of Advanced Malignancies,” Annals of Surgical Oncology 10 (2003): 654–663.
- 2T. J. Miner, M. F. Brennan, and D. P. Jaques, “A Prospective, Symptom Related, Outcomes Analysis of 1022 Palliative Procedures for Advanced Cancer,” Annals of Surgery 240, no. 4 (2004): 719–727.
- 3L. E. McCahill, R. Krouse, D. Chu, et al., “Indications and Use of Palliative Surgery-Results of Society of Surgical Oncology Survey,” Annals of Surgical Oncology 9 (2002): 104–112.
- 4E. J. Lilley, Z. Cooper, M. L. Schwarze, and A. C. Mosenthal, “Palliative Care in Surgery: Defining the Research Priorities,” Annals of Surgery 267, no. 1 (2018): 66–72, https://doi.org/10.1097/SLA.0000000000002253.
- 5K. E. Kopecky, I. S. Florissi, J. B. Greer, and F. M. Johnston, “Palliative Care Interventions for Surgical Patients: A Narrative Review,” Annals of Palliative Medicine 11, no. 11 (2022): 3530–3541, https://doi.org/10.21037/apm-22-770.
- 6J. T. Cohen, R. E. Beard, W. G. Cioffi, and T. J. Miner, “Was It Worth It? Critical Evaluation of a Novel Outcomes Measure in Oncologic Palliative Surgery,” Journal of the American College of Surgeons 236, no. 6 (2023): 1156–1162.
- 7R. S. Krouse, “Surgical Palliation at a Cancer Center: Incidence and Outcomes,” Archives of Surgery 136, no. 7 (2001): 773–778.
- 8C. D. Mann, S. C. Thomasset, N. A. Johnson, et al., “Combined Biliary and Gastric Bypass Procedures as Effective Palliation for Unresectable Malignant Disease,” ANZ Journal of Surgery 79, no. 6 (2009): 471–475.
- 9M. E. Porter, “What Is Value in Health Care?,” New England Journal of Medicine 363, no. 26 (2010): 2477–2481.
- 10D. Moher, PRISMA Group*., “Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement,” Annals of Internal Medicine 151, no. 4 (2009): 264–269.
- 11 Surgeons ACo, “Statement of Principles of Palliative Care,” Updated August, 2005; accessed 8 April, 2024, https://www.facs.org/about-acs/statements/principles-of-palliative-care/.
- 12S. V. S. Deo, N. Kumar, V. K. J. Rajendra, et al., “Palliative Surgery for Advanced Cancer: Clinical Profile, Spectrum of Surgery and Outcomes From a Tertiary Care Cancer Centre in Low-Middle-Income Country,” Indian Journal of Palliative Care 27, no. 2 (2021): 281–285, https://doi.org/10.25259/IJPC_399_20.
- 13M. Ninu, B. Kakati, D. Chintey, and S. D. Kakati, “Perioperative Factors Influencing Outcome in Palliative Cancer Surgery at a Tertiary Cancer Care Institute in Northeast India-A Retrospective Study,” Journal of Clinical and Diagnostic Research 17, no. 2 (2023): UC10–UC15, https://doi.org/10.7860/JCDR/2023/61137.17460.
- 14R. Gonzalez, C. D. Smith, E. M. Ritter, E. Mason, T. Duncan, and B. J. Ramshaw, “Laparoscopic Palliative Surgery for Complicated Colorectal Cancer,” Surgical Endoscopy 19, no. 1 (2005): 43–46, https://doi.org/10.1007/s00464-003-8207-9.
- 15S. Crippa, C. Angelini, C. Mussi, et al., “Surgical Treatment of Metastatic Tumors to the Pancreas: A Single Center Experience and Review of the Literature,” World Journal of Surgery 30, no. 8 (2006): 1536–1542, https://doi.org/10.1007/s00268-005-0464-4.
- 16R. J. Vidri, A. M. Blakely, S. S. Kulkarni, et al., “American College of Surgeons National Surgical Quality Improvement Program as a Quality-Measurement Tool for Advanced Cancer Patients,” Annals of Palliative Medicine 4, no. 4 (2015): 200–206, https://doi.org/10.3978/j.issn.2224-5820.2015.10.01.
- 17M. Lesurtel, N. Dehni, E. Tiret, R. Parc, and F. Paye, “Palliative Surgery for Unresectable Pancreatic and Periampullary Cancer: A Reappraisal,” Journal of Gastrointestinal Surgery 10, no. 2 (2006): 286–291, https://doi.org/10.1016/j.gassur.2005.05.011.
- 18E. De Crescenzo, M. Fontana, G. Dondi, et al., “Malignant Bowel Obstruction in Ovarian Cancer Recurrence: The Role of Palliative Surgery in a Decision-Making Process,” Clinical and Experimental Obstetrics & Gynecology 49, no. 8 (2022): 173, https://doi.org/10.31083/j.ceog4908173.
- 19R. Kawabata, K. Fujitani, K. Sakamaki, et al., “Survival Analysis of a Prospective Multicenter Observational Study on Surgical Palliation Among Patients With Malignant Bowel Obstruction Caused by Peritoneal Dissemination of Gastric Cancer,” Gastric Cancer 25, no. 2 (2022): 422–429, https://doi.org/10.1007/s10120-021-01251-z.
- 20Y. B. Liu, “Surgical Treatment of Patients With Intermediate-Terminal Pancreatic Cancer,” World Journal of Gastroenterology 12, no. 5 (2006): 765–767, https://doi.org/10.3748/wjg.v12.i5.765.
- 21T. You, H. Tang, X. Xu, et al., “Patients With Non-Functional Metastatic G2 Pancreatic Neuroendocrine Tumor Benefit From Palliative Surgery: A 20-year Single-Center Retrospective Analysis,” Journal of Neuroendocrinology 34, no. 12 (2022): e13211, https://doi.org/10.1111/jne.13211.
- 22G. Juarez, B. Ferrell, G. Uman, Y. Podnos, and L. D. Wagman, “Distress and Quality of Life Concerns of Family Caregivers of Patients Undergoing Palliative Surgery,” Cancer Nursing 31, no. 1 (2008): 2–10, https://doi.org/10.1097/01.NCC.0000305682.13766.c2.
- 23J. S. M. Wong, S. M. Lek, D. Y. Z. Lim, et al., “Palliative Gastrointestinal Surgery in Patients With Advanced Peritoneal Carcinomatosis: Clinical Experience and Development of a Predictive Model for Surgical Outcomes,” Frontiers in Oncology 11 (2021): 811743, https://doi.org/10.3389/fonc.2021.811743.
- 24F. Farzaliyev, H. U. Steinau, A. Ring, et al., “Outcome of Surgery as Part of Palliative Care of Patients With Symptomatic Advanced or Metastatic Extra-Abdominal High-Grade Soft Tissue Sarcoma,” Palliative Medicine Reports 3, no. 1 (2023): 64–70, https://doi.org/10.1089/pmr.2022.0063.
- 25N. Fujikuni, K. Tanabe, M. Hattori, et al., “Distal Gastrectomy for Symptomatic Stage IV Gastric Cancer Contributes to Prognosis With Acceptable Safety Compared to Gastrojejunostomy,” Cancers 14, no. 2 (2022): 388, https://doi.org/10.3390/cancers14020388.
- 26S. Yagi, S. Ida, K. Namikawa, et al., “Clinical Outcomes of Palliative Treatment for Gastric Bleeding From Incurable Gastric Cancer,” Surgery Today 53, no. 3 (2023): 360–368, https://doi.org/10.1007/s00595-022-02567-8.
- 27N. V. Maturu, D. R. Pai, and V. N. R. Prasad, “Role of Gastric Bypass in Patients With Unresectable Advanced Carcinoma of Stomach,” Indian Journal of Surgery 69, no. 6 (2007): 237–242, https://doi.org/10.1007/s12262-007-0033-1.
10.1007/s12262-007-0033-1 Google Scholar
- 28S. Mizutani, T. Shioya, K. Maejima, et al., “Significance of Gastrectomy as Palliative Surgery for Gastric Carcinoma With Pyloric Stenosis,” Journal of Nippon Medical School 74, no. 3 (2007): 241–245, https://doi.org/10.1272/jnms.74.241.
- 29S. B. Bateni, R. J. Bold, F. J. Meyers, D. J. Canter, and R. J. Canter, “Comparison of Common Risk Stratification Indices to Predict Outcomes Among Stage IV Cancer Patients With Bowel Obstruction Undergoing Surgery,” Journal of Surgical Oncology 117, no. 3 (2018): 479–487, https://doi.org/10.1002/jso.24866.
- 30H. Ptok, F. Marusch, R. Steinert, L. Meyer, H. Lippert, and I. Gastinger, “Incurable Stenosing Colorectal Carcinoma: Endoscopic Stent Implantation or Palliative Surgery?,” World Journal of Surgery 30, no. 8 (2006): 1481–1487, https://doi.org/10.1007/s00268-005-0513-z.
- 31P. J. Kneuertz, S. C. Cunningham, J. L. Cameron, et al., “Palliative Surgical Management of Patients With Unresectable Pancreatic Adenocarcinoma: Trends and Lessons Learned From a Large, Single Institution Experience,” Journal of Gastrointestinal Surgery 15, no. 11 (2011): 1917–1927, https://doi.org/10.1007/s11605-011-1665-9.
- 32P. Hermanek and C. Wittekind, “The Pathologist and the Residual Tumor (R) Classification,” Pathology-Research and Practice 190, no. 2 (1994): 115–123.
- 33H. J. Lee, S. P. Hong, J. H. Cheon, et al., “Long-Term Outcome of Palliative Therapy for Malignant Colorectal Obstruction in Patients With Unresectable Metastatic Colorectal Cancers: Endoscopic Stenting Versus Surgery,” Gastrointestinal Endoscopy 73, no. 3 (2011): 535–542, https://doi.org/10.1016/j.gie.2010.10.052.
- 34C. D. Mann, M. G. A. Norwood, A. S. Miller, and D. Hemingway, “Nonresectional Palliative Abdominal Surgery for Patients With Advanced Colorectal Cancer,” Colorectal Disease 12, no. 10 (2010): 1039–1043, https://doi.org/10.1111/j.1463-1318.2009.01926.x.
- 35Y. D. Podnos, G. Juarez, C. Pameijer, K. Choi, B. R. Ferrell, and L. D. Wagman, “Impact of Surgical Palliation on Quality of Life in Patients With Advanced Malignancy: Results of the Decisions and Outcomes in Palliative Surgery (Dops) Trial,” Annals of Surgical Oncology 14, no. 2 (2007): 922–928, https://doi.org/10.1245/s10434-006-9238-y.
- 36J. Walter, A. Nier, T. Rose, et al., “Palliative Partial Pancreaticoduodenectomy Impairs Quality of Life Compared to Bypass Surgery in Patients With Advanced Adenocarcinoma of the Pancreatic Head,” European Journal of Surgical Oncology (EJSO) 37, no. 9 (2011): 798–804, https://doi.org/10.1016/j.ejso.2011.06.017.
- 37I. G. Faragher, I. M. Chaitowitz, and D. A. Stupart, “Long-Term Results of Palliative Stenting or Surgery for Incurable Obstructing Colon Cancer,” Colorectal Disease 10, no. 7 (2008): 668–672, https://doi.org/10.1111/j.1463-1318.2007.01446.x.
- 38M. J. Kang, Y. Song, J. Y. Jang, I. W. Han, and S. W. Kim, “Role of Radical Surgery in Patients With Stage IV Gallbladder Cancer,” HPB (Oxford) 14, no. 12 (2012): 805–811, https://doi.org/10.1111/j.1477-2574.2012.00544.x.
- 39Y. Nagashima, K. Funahashi, S. Kagami, et al., “Which Preoperative Immunonutritional Index Best Predicts Postoperative Mortality After Palliative Surgery for Malignant Bowel Obstruction in Patients With Late-Stage Cancer? A Single-Center Study in Japan Comparing the Modified Glasgow Prognostic Score (M),” Surgery Today 53, no. 1 (2023): 22–30, https://doi.org/10.1007/s00595-022-02534-3.
- 40I. M. Khan, M. Aurangzeb, U. R. Mujeeb-ur-rahman, and M. Tayyab, “Palliative Surgery for Pancreatic Carcinoma,” Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 20, no. 11 (2010): 719–722.
- 41E. Sartori, F. Chiudinelli, B. Pasinetti, B. Sostegni, and T. Maggino, “Possible Role of Palliative Surgery for Bowel Obstruction in Advanced Ovarian Cancer Patients,” European Journal of Gynaecological Oncology 31, no. 1 (2010): 31–36.
- 42H. Nishigori, M. Ito, Y. Nishizawa, et al., “Laparoscopic Surgery for Palliative Resection of the Primary Tumor in Incurable Stage IV Colorectal Cancer,” Surgical Endoscopy 26, no. 11 (2012): 3201–3206, https://doi.org/10.1007/s00464-012-2323-3.
- 43P. H. Sugarbaker and D. Chang, “Palliation of Mucinous Appendiceal Neoplasms With Peritoneal Metastases With Total Abdominal Colectomy,” Journal of Surgical Oncology 127, no. 6 (2023): 1019–1027, https://doi.org/10.1002/jso.27220.
- 44Y. L. B. Klaver, V. E. P. P. Lemmens, and I. H. J. T. de Hingh, “Outcome of Surgery for Colorectal Cancer in the Presence of Peritoneal Carcinomatosis,” European Journal of Surgical Oncology (EJSO) 39, no. 7 (2013): 734–741, https://doi.org/10.1016/j.ejso.2013.03.003.
- 45B. Badgwell, E. Bruera, and S. V. Klimberg, “Can Patient Reported Outcomes Help Identify the Optimal Outcome in Palliative Surgery?,” Journal of Surgical Oncology 109, no. 2 (2014): 145–150, https://doi.org/10.1002/jso.23466.
- 46A. M. Blakely, D. S. Heffernan, J. McPhillips, W. G. Cioffi, and T. J. Miner, “Elevated C-Reactive Protein as a Predictor of Patient Outcomes Following Palliative Surgery,” Journal of Surgical Oncology 110, no. 6 (2014): 651–655, https://doi.org/10.1002/jso.23682.
- 47C. Mariette, E. Bruyère, M. Messager, et al., “Palliative Resection for Advanced Gastric and Junctional Adenocarcinoma: Which Patients Will Benefit From Surgery?,” Annals of Surgical Oncology 20, no. 4 (2013): 1240–1249, https://doi.org/10.1245/s10434-012-2687-6.
- 48K. Mimatsu, T. Oida, N. Fukino, et al., “Glasgow Prognostic Score Is a Useful Predictive Factor of Outcome After Palliative Gastrectomy for Stage IV Gastric Cancer,” Anticancer Research 34, no. 6 (2014): 3131–3136.
- 49Y. S. Yoon, C. W. Kim, S. B. Lim, et al., “Palliative Surgery in Patients With Unresectable Colorectal Liver Metastases: A Propensity Score Matching Analysis,” Journal of Surgical Oncology 109, no. 3 (2014): 239–244, https://doi.org/10.1002/jso.23480.
- 50H. J. Ahn, S. W. Kim, S. W. Lee, et al., “Long-Term Outcomes of Palliation for Unresectable Colorectal Cancer Obstruction in Patients With Good Performance Status: Endoscopic Stent Versus Surgery,” Surgical Endoscopy 30, no. 11 (2016): 4765–4775, https://doi.org/10.1007/s00464-016-4804-2.
- 51F. O. Hofmann, R. C. Miksch, M. Weniger, et al., “Outcomes and Risks in Palliative Pancreatic Surgery: An Analysis of the German StuDoQ|Pancreas Registry,” BMC Surgery 22, no. 1 (2022): 389, https://doi.org/10.1186/s12893-022-01833-3.
- 52L. F. Oñate-Ocaña, G. Méndez-Cruz, R. Hernández-Ramos, et al., “Experience of Surgical Morbidity After Palliative Surgery in Patients With Gastric Carcinoma,” Gastric Cancer 10, no. 4 (2007): 215–220, https://doi.org/10.1007/s10120-007-0437-4.
- 53M. He, D. Zhang, F. Wang, et al., “The Role of Non-Curative Surgery in Incurable, Asymptomatic Advanced Gastric Cancer,” PLoS One 8, no. 12 (2013): e83921, https://doi.org/10.1371/journal.pone.0083921.
- 54H. K. Sigurdsson, H. Kørner, O. Dahl, A. Skarstein, and J. A. Søreide, “Palliative Surgery for Rectal Cancer in a National Cohort,” Colorectal Disease 10, no. 4 (2008): 336–343, https://doi.org/10.1111/j.1463-1318.2007.01376.x.
- 55K. Maeda, M. Shibutani, H. Otani, et al., “Prognostic Value of Preoperative Inflammation-Based Prognostic Scores in Patients With Stage IV Colorectal Cancer Who Undergo Palliative Resection of Asymptomatic Primary Tumors,” Anticancer Research 33, no. 12 (2013): 5567–5573.
- 56E. K. Bartlett, H. Wachtel, D. L. Fraker, et al., “Surgical Palliation for Pancreatic Malignancy: Practice Patterns and Predictors of Morbidity and Mortality,” Journal of Gastrointestinal Surgery 18, no. 7 (2014): 1292–1298, https://doi.org/10.1007/s11605-014-2502-8.
- 57T. H. Wong and Y. M. Tan, “Surgery for the Palliation of Intestinal Obstruction in Advanced Abdominal Malignancy,” Singapore Medical Journal 50, no. 12 (2009): 1139–1144.
- 58T. D. Hamilton, D. Selby, M. E. Tsang, A. Kim, and F. C. Wright, “Patients’ Perceptions of Palliative Surgical Procedures: a Qualitative Analysis,” Annals of Palliative Medicine 6, no. Suppl 1 (2017): S77–S84, https://doi.org/10.21037/apm.2017.01.04.
- 59M. Ercan, E. B. Bostanci, T. Cakir, et al., “The Rationality of Resectional Surgery and Palliative Interventions in the Management of Patients With Gallbladder Cancer,” The American Surgeon 81, no. 6 (2015): 591–599.
- 60A. Razak O, S. Y. Yang, M. S. Cho, B. S. Min, and Y. D. Han, “Palliative Surgery as a Bridge to Systemic Treatment for Malignant Bowel Obstruction Due to Peritoneal Metastases: A Retrospective, Case-Control Study,” Asian Journal of Surgery 46, no. 1 (2023): 160–165, https://doi.org/10.1016/j.asjsur.2022.02.028.
- 61T. Perri, J. Korach, G. Ben-Baruch, et al., “Bowel Obstruction in Recurrent Gynecologic Malignancies: Defining Who Will Benefit From Surgical Intervention,” European Journal of Surgical Oncology (EJSO) 40, no. 7 (2014): 899–904, https://doi.org/10.1016/j.ejso.2013.10.025.
- 62S. D. Nelen, M. van Putten, V. E. P. P. Lemmens, K. Bosscha, J. H. W. de Wilt, and R. H. A. Verhoeven, “Effect of Age on Rates of Palliative Surgery and Chemotherapy Use in Patients With Locally Advanced or Metastatic Gastric Cancer,” British Journal of Surgery 104, no. 13 (2017): 1837–1846, https://doi.org/10.1002/bjs.10621.
- 63J. A. Funder, K. V. Jepsen, K. Stribolt, and L. H. Iversen, “Palliative Surgery for Pseudomyxoma Peritonei,” Scandinavian Journal of Surgery 105, no. 2 (2016): 84–89, https://doi.org/10.1177/1457496915598759.
- 64C. Pickard, R. Thomas, I. Robertson, and A. Macdonald, “Ostomy Creation for Palliative Care of Patients With Nonresectable Colorectal Cancer and Bowel Obstruction,” Journal of Wound, Ostomy & Continence Nursing 45, no. 3 (2018): 239–241, https://doi.org/10.1097/WON.0000000000000424.
- 65Y. Maeda, T. Shinohara, T. Katayama, et al., “A Laparoscopic Approach Is Associated With a Decreased Incidence of SSI in Patients Undergoing Palliative Surgery for Malignant Bowel Obstruction,” International Journal of Surgery 42 (2017): 90–94, https://doi.org/10.1016/j.ijsu.2017.04.052.
- 66S. B. Bateni, A. A. Gingrich, S. L. Stewart, F. J. Meyers, R. J. Bold, and R. J. Canter, “Hospital Utilization and Disposition Among Patients With Malignant Bowel Obstruction: A Population-Based Comparison of Surgical to Medical Management,” BMC Cancer 18, no. 1 (2018): 1166, https://doi.org/10.1186/s12885-018-5108-9.
- 67C. Lindvall, E. J. Lilley, S. N. Zupanc, et al., “Natural Language Processing to Assess End-of-Life Quality Indicators in Cancer Patients Receiving Palliative Surgery,” Journal of Palliative Medicine 22, no. 2 (2019): 183–187, https://doi.org/10.1089/jpm.2018.0326.
- 68H. B. Qiu, Z. G. Zhou, X. Y. Feng, et al., “Advanced Gastrointestinal Stromal Tumor Patients Benefit From Palliative Surgery After Tyrosine Kinase Inhibitors Therapy,” Medicine 97, no. 2 (2018): e9097, https://doi.org/10.1097/MD.0000000000009097.
- 69S. Z. Lin, H. F. Tong, T. You, et al., “Palliative Gastrectomy and Chemotherapy for Stage IV Gastric Cancer,” Journal of Cancer Research and Clinical Oncology 134, no. 2 (2007): 187–192, https://doi.org/10.1007/s00432-007-0268-z.
- 70Z. B. He, M. Jiang, W. B. Niu, et al., “Palliative Bypass Surgery in Elderly Patients With Resectable Periampullary Carcinoma: A Report of 45 Cases,” Translational Cancer Research 8, no. 4 (2019): 1336–1341, https://doi.org/10.21037/tcr.2019.07.22.
- 71M. Sano, S. Asaka, M. Satake, et al., “Palliative Surgery for Malignant Gastrointestinal Obstruction: A Community Hospital Experience,” Annals of Cancer Research and Therapy 27, no. 2 (2019): 80–82, https://doi.org/10.4993/acrt.27.80.
10.4993/acrt.27.80 Google Scholar
- 72A. Blažević, W. T. Zandee, G. J. H. Franssen, et al., “Mesenteric Fibrosis and Palliative Surgery in Small Intestinal Neuroendocrine Tumours,” Endocrine-Related Cancer 25, no. 3 (2018): 245–254, https://doi.org/10.1530/ERC-17-0282.
- 73N. L. de Boer, J. A. W. Hagemans, B. T. A. Schultze, et al., “Acute Malignant Obstruction in Patients With Peritoneal Carcinomatosis: The Role of Palliative Surgery,” European Journal of Surgical Oncology 45, no. 3 (2019): 389–393, https://doi.org/10.1016/j.ejso.2018.12.015.
- 74A. Akbaş, “Does a Selective Surgical Approach to Malignant Bowel Obstruction Help in Palliative Care Patients?,” Turkish Journal of Trauma and Emergency Surgery 26, no. 6 (2023): 875–882, https://doi.org/10.14744/tjtes.2020.90250.
10.14744/tjtes.2020.90250 Google Scholar
- 75X. Liang, J. Zhu, Y. Li, et al., “Treatment Strategies for Metastatic Gastric Cancer: Chemotherapy, Palliative Surgery or Radiotherapy?,” Future Oncology 16, no. 5 (2020): 91–102, https://doi.org/10.2217/fon-2019-0495.
- 76P. J. Chen, L. Wang, Y. F. Peng, N. Chen, and A. W. Wu, “Surgical Intervention for Malignant Bowel Obstruction Caused by Gastrointestinal Malignancies,” World Journal of Gastrointestinal Oncology 12, no. 3 (2020): 323–331, https://doi.org/10.4251/WJGO.V12.I3.323.
- 77S. Ministrini, M. Bencivenga, L. Solaini, et al., “Stage IV Gastric Cancer: The Surgical Perspective of the Italian Research Group on Gastric Cancer,” Cancers 12, no. 1 (2020): 158, https://doi.org/10.3390/cancers12010158.
- 78N. Pencovich, L. Orbach, Y. Lessing, et al., “Palliative Bypass Surgery for Patients With Advanced Pancreatic Adenocarcinoma: Experience From a Tertiary Center,” World Journal of Surgical Oncology 18, no. 1 (2020): 63, https://doi.org/10.1186/s12957-020-01828-5.
- 79G. Fujimoto, H. Kusanagi, K. Hayashi, A. Miyazaki, H. Honjo, and M. Nakagi, “Impact of Gastrectomy for Incurable Advanced Gastric Cancer in Urgent Situations in the Elderly,” Asian Journal of Surgery 46, no. 1 (2023): 514–519, https://doi.org/10.1016/j.asjsur.2022.06.001.
- 80C. L. Li, D. R. Tang, J. Ji, B. Zang, C. Chen, and J. Q. Zhao, “Colorectal Adenocarcinoma Patients With M1a Diseases Gain More Clinical Benefits From Palliative Primary Tumor Resection Than Those With M1b Diseases: A Propensity Score Matching Analysis,” World Journal of Clinical Cases 8, no. 15 (2020): 3230–3239, https://doi.org/10.12998/WJCC.V8.I15.3230.
- 81E. Fiori, D. Crocetti, P. Sapienza, et al., “Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL,” Medicina 57, no. 5 (2021): 428, https://doi.org/10.3390/medicina57050428.
- 82J. Y. Yoon, S. J. Park, S. P. Hong, T. I. Kim, W. H. Kim, and J. H. Cheon, “Outcomes of Secondary Self-Expandable Metal Stents Versus Surgery After Delayed Initial Palliative Stent Failure in Malignant Colorectal Obstruction,” Digestion 88, no. 1 (2013): 46–55, https://doi.org/10.1159/000351208.
- 83B. Kennedy, K. Sexton, and N. Gleeson, “Outcomes of Palliative Surgery for Bowel Obstruction in End of Life Ovarian Cancer Care in a Tertiary Cancer Centre,” European Journal of Gynaecological Oncology 42, no. 6 (2021): 1112–1115, https://doi.org/10.31083/j.ejgo4206162.
- 84J. Pelletier, S. J. Cyr, A. S. Julien, Y. Fradet, L. Lacombe, and P. Toren, “Contemporary Outcomes of Palliative Transurethral Resection of the Prostate in Patients With Locally Advanced Prostate Cancer,” Urologic Oncology: Seminars and Original Investigations 36, no. 8 (2018): 363.e7–363.e11, https://doi.org/10.1016/j.urolonc.2018.05.004.
- 85V. Jaruvongvanich, F. Chesta, A. Baruah, et al., “Palliative Treatment for Malignant Gastrointestinal Obstruction With Peritoneal Carcinomatosis: Enteral Stenting Versus Surgery,” Endoscopy International Open 08, no. 10 (2020): E1487–E1494, https://doi.org/10.1055/a-1237-3956.
- 86S. Buettner, A. Wilson, G. A. Margonis, et al., “Assessing Trends in Palliative Surgery for Extrahepatic Biliary Malignancies: A 15-Year Multicenter Study,” Journal of Gastrointestinal Surgery 20, no. 8 (2016): 1444–1452, https://doi.org/10.1007/s11605-016-3155-6.
- 87D. W. J. Ng, M. C. C. Teo, A. C. P. Yee, K. H. Ng, and T. H. Wong, “Surgery for the Palliation of Intestinal Perforation From Secondary Metastases in Advanced Malignancies,” Asia-Pacific Journal of Clinical Oncology 12, no. 4 (2016): 453–459, https://doi.org/10.1111/ajco.12466.
- 88M. Terashima, K. Fujitani, M. Ando, et al., “Survival Analysis of a Prospective Multicenter Observational Study on Surgical Palliation Among Patients Receiving Treatment for Malignant Gastric Outlet Obstruction Caused by Incurable Advanced Gastric Cancer,” Gastric Cancer 24, no. 1 (2021): 224–231, https://doi.org/10.1007/s10120-020-01114-z.
- 89T. Nakano, H. Tsubochi, M. Maki, et al., “Can the Japanese National Clinical Database Risk Calculator Predict Long-Term Survival of Patients Who Undergo Palliative Segmentectomy for Primary Lung Cancer?,” General Thoracic and Cardiovascular Surgery 69, no. 7 (2021): 1096–1104, https://doi.org/10.1007/s11748-021-01585-6.
- 90G. Gallino, A. Maurichi, R. Patuzzo, et al., “Surgical Treatment of Melanoma Metastases to the Small Bowel: A Single Cancer Referral Center Real-Life Experience,” European Journal of Surgical Oncology 47, no. 2 (2021): 409–415, https://doi.org/10.1016/j.ejso.2020.08.025.
- 91Y. Wang, Z. Man, X. Hu, et al., “Percutaneous Biliary Stent With Intraluminal Brachytherapy Versus Palliative Surgery in the Management of Extrahepatic Cholangiocarcinoma,” International Journal of Clinical Oncology 26, no. 5 (2021): 933–940, https://doi.org/10.1007/s10147-021-01877-0.
- 92Y. Ito, K. Fujitani, K. Sakamaki, et al., “Qol Assessment After Palliative Surgery for Malignant Bowel Obstruction Caused by Peritoneal Dissemination of Gastric Cancer: A Prospective Multicenter Observational Study,” Gastric Cancer 24, no. 5 (2021): 1131–1139, https://doi.org/10.1007/s10120-021-01179-4.
- 93T. Goto, M. Takano, T. Aoyama, et al., “Outcomes of Palliative Bowel Surgery for Malignant Bowel Obstruction in Patients With Gynecological Malignancy,” Oncology Letters 4, no. 5 (2012): 883–888, https://doi.org/10.3892/ol.2012.835.
- 94E. A. Strong, A. Livingston, M. Gracz, et al., “Palliative Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis: Is It Safe and Effective?,” Journal of Surgical Research 278 (2022): 31–38, https://doi.org/10.1016/j.jss.2022.04.012.
- 95W. J. Tan, M. H. Chew, I. B. H. Tan, et al., “Palliative Surgical Intervention in Metastatic Colorectal Carcinoma: A Prospective Analysis of Quality of Life,” Colorectal Disease 18, no. 4 (2016): 357–363, https://doi.org/10.1111/codi.13142.
- 96E. Sahlström, J. Nilsson, B. Tingstedt, M. Bergenfeldt, R. Andersson, and B. Andersson, “Surgical Exploration Without Resection in Pancreatic and Periampullary Tumors: Report From a National Database,” Scandinavian Journal of Surgery 110, no. 3 (2021): 344–350, https://doi.org/10.1177/1457496920913669.
- 97J. T. Cohen, E. A. Fallon, K. P. Charpentier, W. G. Cioffi, and T. J. Miner, “Improving the Value of Palliative Surgery by Optimizing Patient Selection,” The American Journal of Surgery 221, no. 5 (2021): 1018–1023, https://doi.org/10.1016/j.amjsurg.2020.08.034.
- 98N. Zongo, P. B. Yameogo, J. T. Savadogo, A. H. Bagué, and A. Dem, “The Outcomes of Palliative Surgical Treatment in a Context of Rising Incidence of Gastro Intestinal Cancers in Burkina Faso, Africa,” European Journal of Surgical Oncology 48, no. 10 (2022): 2174–2180, https://doi.org/10.1016/j.ejso.2022.07.002.
- 99A. Nohria, S. R. Kaslow, L. Hani, et al., “Outcomes After Surgical Palliation of Patients With Gastric Cancer,” Journal of Surgical Research 279 (2022): 304–311, https://doi.org/10.1016/j.jss.2022.06.018.
- 100L. Fornaro, V. Fanotto, G. Musettini, et al., “Selecting Patients for Gastrectomy in Metastatic Esophago-Gastric Cancer: Clinics and Pathology Are Not Enough,” Future Oncology 13, no. 25 (2017): 2265–2275, https://doi.org/10.2217/fon-2017-0246.
- 101T. Ojima, M. Nakamori, M. Nakamura, M. Katsuda, K. Hayata, and H. Yamaue, “Laparoscopic Gastrojejunostomy for Patients With Unresectable Gastric Cancer With Gastric Outlet Obstruction,” Journal of Gastrointestinal Surgery 21, no. 8 (2017): 1220–1225, https://doi.org/10.1007/s11605-017-3387-0.
- 102S. J. Jeong, Y. S. Yoon, J. B. Lee, et al., “Palliative Surgery for Colorectal Cancer With Peritoneal Metastasis: A Propensity-Score Matching Analysis,” Surgery Today 47, no. 2 (2017): 159–165, https://doi.org/10.1007/s00595-016-1402-9.
- 103D. F. Kolomainen, A. Daponte, D. P. J. Barton, et al., “Outcomes of Surgical Management of Bowel Obstruction in Relapsed Epithelial Ovarian Cancer (EOC),” Gynecologic Oncology 125, no. 1 (2012): 31–36, https://doi.org/10.1016/j.ygyno.2011.11.007.
- 104J. T. Cohen and T. J. Miner, “Who Should Decide When Palliative Surgery Is Justifiable?,” AMA Journal of Ethics 23, no. 10 (2021): 761–765.
10.1001/amajethics.2021.761 Google Scholar
