Can patient reported outcomes help identify the optimal outcome in palliative surgery?

J Surg Oncol. 2014 Feb;109(2):145-50. doi: 10.1002/jso.23466. Epub 2013 Oct 16.

Abstract

Background: The purpose of this pilot study was to determine whether an open-ended questionnaire captures severe symptoms in cancer patients undergoing palliative surgical consultation that a structured, validated quality-of-life assessment does not capture.

Methods: We prospectively used the Functional Assessment of Cancer Therapy-General (FACT-G) and an open-ended questionnaire to assess the symptoms of patients with incurable malignancies who underwent palliative surgical consultation at our institution between January 2011 and September 2012.

Results: Of the 69 patients enrolled, the most common indications for consultation were bowel obstruction (54%), jaundice (13%), wound problems (10%), and gastrointestinal bleeding (7%). Of the severe symptoms patients reported, 76% were identified with the FACT-G alone, 22% were identified with the open-ended questionnaire alone, and 2% were duplicate responses captured with both the FACT-G and open-ended questionnaire. The open-ended questionnaire captured 68 instances of severe symptoms in 47 patients that the FACT-G did not capture; of these symptoms, 52 were considered to be highly relevant to surgery and potential outcome measures.

Conclusions: An open-ended questionnaire can identify severe symptoms that a global quality of life survey cannot capture and could be used in conjunction with a global survey to reassess symptoms after palliative surgical consultation.

Keywords: advanced cancer; palliative surgery; patient reported outcomes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intestinal Obstruction / etiology
  • Jaundice / etiology
  • Male
  • Middle Aged
  • Nausea / etiology
  • Neoplasms / complications*
  • Neoplasms / psychology
  • Neoplasms / surgery*
  • Pain / etiology
  • Palliative Care*
  • Patient Outcome Assessment*
  • Pilot Projects
  • Prospective Studies
  • Quality of Life
  • Surveys and Questionnaires*