A Prospective Evaluation of Palliative Outcomes of Surgery for Advanced Malignancies

2.50
Hdl Handle:
http://hdl.handle.net/10755/165390
Category:
Abstract
Type:
Presentation
Title:
A Prospective Evaluation of Palliative Outcomes of Surgery for Advanced Malignancies
Author(s):
Ferrell, Betty; Smith, D.; Borneman, T.; McCahill, L.; Chu, D.; Juarez, G.
Author Details:
Betty Ferrell, PhD, Research Scientist, City of Hope National Medical Center, Duarte, California, USA, email: bferrell@smtplink.coh.org; D. Smith; T. Borneman; L. McCahill; D. Chu; G. Juarez
Abstract:
Surgery for malignant disease has focused on patient survival with less focus on the role of surgery in improved Quality of Life (QOL). Palliative surgery can improve QOL by relieving symptoms related to advanced malignancy. The purpose of this study was to evaluate patient outcomes following surgery. The QOL framework (Ferrell & Grant) and a Clinical Decision-Making model served as the study theoretical framework. The sample included 59 patients who required a major operation and had advanced malignancy. Methods included medical record review and symptom assessment performed pre-operatively and at 2, 6 and 12 weeks postoperatively utilizing the Memorial Symptom Assessment Scale (MSAS) and the City of Hope QOL instrument. Data were analyzed using descriptive statistics and repeated measures analysis. Findings indicate that surgical indications were resection of recurrent disease (n=28, 47%), metastasectomy (n=17, 28%), or initial resection (n=14, 24%) for gastrointestinal malignancy (n=28, 47%), sarcoma (n=16, 27%), and other (n=15, 25%). The mean age was 58.5 years, M:F 28:31, hospital stay was 8.5 days (2-24), and 30-day mortality was 3/59 (5%). Six-month survival was 62%. Symptoms intended to treat among 33 symptomatic patients were pain (27/33, 82%), heaviness/pressure (7), tumor discharge/malodor (6), nausea/vomiting (6), and bleeding (4), with 20/33 (61%) reporting multiple severe symptoms. Other moderate to severe symptoms (= 2 on a 1-4 MSAS scale, 4=very severe) reported were lethargy (46%), worrying (32%), lack of appetite (30%), difficulty sleeping (28%), nervousness (26%) and feeling sad (25%). While global QOL indices were unchanged at 3 months compared to baseline (MSAS-1.1, p=0.3, QOL + 0.04, p=0.97), symptom improvement for patients with symptom severity scores > 2 on MSAS scale were documented for pain (-1.17, p=.001), itching (-2.61, p=.001), vomiting (-2.14, p=.02), and lack of appetite (-1.55, p=.01). Findings suggest that symptomatic patients undergoing surgery for advanced malignancies can attain symptom relief. QOL outcomes can guide clinical decision making and study findings suggests that surgery is an important component of palliative care. Advanced the understanding of the needs of patients undergoing palliative surgery and its impact on QOL is an important aspect of cancer care.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2003
Conference Name:
28th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Denver, Colorado, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleA Prospective Evaluation of Palliative Outcomes of Surgery for Advanced Malignanciesen_GB
dc.contributor.authorFerrell, Bettyen_US
dc.contributor.authorSmith, D.en_US
dc.contributor.authorBorneman, T.en_US
dc.contributor.authorMcCahill, L.en_US
dc.contributor.authorChu, D.en_US
dc.contributor.authorJuarez, G.en_US
dc.author.detailsBetty Ferrell, PhD, Research Scientist, City of Hope National Medical Center, Duarte, California, USA, email: bferrell@smtplink.coh.org; D. Smith; T. Borneman; L. McCahill; D. Chu; G. Juarezen_US
dc.identifier.urihttp://hdl.handle.net/10755/165390-
dc.description.abstractSurgery for malignant disease has focused on patient survival with less focus on the role of surgery in improved Quality of Life (QOL). Palliative surgery can improve QOL by relieving symptoms related to advanced malignancy. The purpose of this study was to evaluate patient outcomes following surgery. The QOL framework (Ferrell & Grant) and a Clinical Decision-Making model served as the study theoretical framework. The sample included 59 patients who required a major operation and had advanced malignancy. Methods included medical record review and symptom assessment performed pre-operatively and at 2, 6 and 12 weeks postoperatively utilizing the Memorial Symptom Assessment Scale (MSAS) and the City of Hope QOL instrument. Data were analyzed using descriptive statistics and repeated measures analysis. Findings indicate that surgical indications were resection of recurrent disease (n=28, 47%), metastasectomy (n=17, 28%), or initial resection (n=14, 24%) for gastrointestinal malignancy (n=28, 47%), sarcoma (n=16, 27%), and other (n=15, 25%). The mean age was 58.5 years, M:F 28:31, hospital stay was 8.5 days (2-24), and 30-day mortality was 3/59 (5%). Six-month survival was 62%. Symptoms intended to treat among 33 symptomatic patients were pain (27/33, 82%), heaviness/pressure (7), tumor discharge/malodor (6), nausea/vomiting (6), and bleeding (4), with 20/33 (61%) reporting multiple severe symptoms. Other moderate to severe symptoms (= 2 on a 1-4 MSAS scale, 4=very severe) reported were lethargy (46%), worrying (32%), lack of appetite (30%), difficulty sleeping (28%), nervousness (26%) and feeling sad (25%). While global QOL indices were unchanged at 3 months compared to baseline (MSAS-1.1, p=0.3, QOL + 0.04, p=0.97), symptom improvement for patients with symptom severity scores > 2 on MSAS scale were documented for pain (-1.17, p=.001), itching (-2.61, p=.001), vomiting (-2.14, p=.02), and lack of appetite (-1.55, p=.01). Findings suggest that symptomatic patients undergoing surgery for advanced malignancies can attain symptom relief. QOL outcomes can guide clinical decision making and study findings suggests that surgery is an important component of palliative care. Advanced the understanding of the needs of patients undergoing palliative surgery and its impact on QOL is an important aspect of cancer care.en_GB
dc.date.available2011-10-27T12:17:41Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:17:41Z-
dc.conference.date2003en_US
dc.conference.name28th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationDenver, Colorado, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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