P76: Surgeon Perspectives on Management of Aborted Cancer Surgery: Results of an SSO Member Survey

Thursday, March 23, 2023

3:56 PM – 4:01 PM

Location: SSO HUB: Rare/Metastatic Cancers Zone

Poster Presenter(s)

Alexandra G. Lopez-Aguiar, MD, MS (she/her/hers)

Surgical Oncology Fellow
The Ohio State University Wexner Medical Center
Columbus, Ohio, United States

Disclosure information not submitted.

Author(s)

Alexandra G. Lopez-Aguiar, MD, MS (she/her/hers)

Surgical Oncology Fellow
The Ohio State University Wexner Medical Center
Columbus, Ohio, United States

Disclosure information not submitted.
AS

Angela Sarna, BS

Project Manager
The Ohio State University, United States

Disclosure information not submitted.
SW

Sharla Wells-DiGregorio, PhD

Psychologist
The Ohio State University Wexner Medical Center, United States

Disclosure information not submitted.
SK

Sachin Kale, MD

Associate Professor
The Ohio State University Wexner Medical Center, United States

Disclosure information not submitted.
ES

Erin Scott, MD

Assistant Professor
The Ohio State University Wexner Medical Center, United States

Disclosure information not submitted.
Aslam Ejaz, MD, MPH

Assistant Professor of Surgery
The Ohio State University

Disclosure information not submitted.
Timothy M. Pawlik, MD, PhD

Chair of Surgery
The Ohio State University Wexner Medical Center
Columbus, Ohio, United States

Disclosure(s): No financial relationships to disclose
Jordan M. Cloyd, MD

Assistant Professor
The Ohio State University
Columbus, OH, United States

Disclosure information not submitted.

Disclosure(s):

Timothy M. Pawlik, MD, PhD: No financial relationships to disclose

Introduction: While resection is generally necessary for most solid-organ cancers, curative-intent surgery is occasionally unexpectedly aborted despite careful planning and high quality imaging. Nevertheless, little research has been performed on the unique care needs of patients following aborted cancer surgery (ACS). The aim of this study was to measure the practice patterns and perspectives of an international cohort of cancer surgeons on the management of ACS.

Methods: A validated survey assessing surgeon perspectives on patient care needs following ACS was developed using evidence synthesis, patient interviews, and preliminary survey results and then distributed electronically to members of the Society of Surgical Oncology (SSO).

Results: Among 190 participating surgeons, mean age was 49±11 years and 69% were male. Mean time since completion of training was 15±12 years, 61% worked at an academic institution, and most responders had a clinical practice focused on liver/pancreas (30%), breast (23%), and melanoma/sarcoma (20%). Participants reported ACS to occur in 7±6% of operations, in accordance with national averages. The most common reasons for aborting were occult metastases (67%) and local unresectability (30%). Provider perception of patient experiences following ACS were thought to include most often symptoms from their cancer (41%), uncertainty/anxiety about next steps (35%), and prolonged recovery from surgery (13%). While discussing next available therapies was felt to be patients’ most important priority after ACS, the most important priority for surgeons was patient recovery without complication (Figure 1a; p< 0.001). Most surgeons felt comfortable or very comfortable addressing their patients’ surgical needs (92%) and cancer treatment related questions (90%), but only 69% and 83% felt (very) comfortable addressing psychosocial and symptom-control needs, respectively (Figure 1b; p=0.012). While 71% reported utilizing palliative care in these situations, 46% noted care coordination among teams as a barrier to addressing patient care needs. Nearly all felt that additional research on patient care needs following ACS is important (99%).

Conclusions: Results from this SSO member survey suggest that aborted cancer surgery is relatively common and associated with unique patient care needs. As surgeons may feel less comfortable assessing psychosocial and symptom-control needs, novel patient-centered, multidisciplinary approaches should be developed.

Learning Objectives:

Upon completion, participants will be able to list the most common reasons for aborted cancer surgeries.
Upon completion, participants will be able to identify differences in patient and surgeon priorities following aborted cancer surgeries.
Upon completion, participants will be able to describe patient care needs that surgeons are less comfortable with following aborted cancer surgeries.