Surgical Treatment Intensity at the End of Life in Cancer Patients
Author Information
Author(s): Lawday Samuel BMBS, MByRes, Zucker Benjamin E. MA, MBBS, MRCS, Gardner Shona MBChB, MRCS, Robb James MBChB, MA, Leandro Lorna MA, BM, BCh, Hollingworth William PhD, Blazeby Jane MBChB, MD, McNair Angus G.K. PhD, FRCS, Chamberlain Charlotte PhD, MRCP
Primary Institution: NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
Hypothesis
What is the intensity of surgical treatment received by cancer patients at the end of life?
Conclusion
A significant proportion of cancer patients undergo invasive procedures at the end of life, with considerable variation in reporting and patient inclusion criteria.
Supporting Evidence
- Up to 79% of patients underwent invasive procedures in the last month of life.
- There is significant reporting heterogeneity in the literature regarding surgical care at the end of life.
- Younger patients and those with higher household incomes tend to receive more aggressive treatment.
Takeaway
Many cancer patients have surgeries in their last days, but it's unclear if these surgeries help them or just add to their suffering.
Methodology
This systematic review followed PRISMA guidelines and included observational studies on surgical intensity at the end of life in adult cancer patients.
Potential Biases
High or moderate risk of bias was identified in 23 studies due to unrepresentative samples and retrospective data.
Limitations
There is significant heterogeneity in reporting practices and patient inclusion criteria across studies, making it difficult to draw definitive conclusions.
Participant Demographics
The studies included a range of cancer types and demographics, with a median sample size of 8814 participants.
Digital Object Identifier (DOI)
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