caa a22 4500 445334649 CHVBK 20180317142750.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1245/s10434-011-1787-z doi (NATIONALLICENCE)springer-10.1245/s10434-011-1787-z When a Chance to Cut Is Not a Chance to Cure: A Future for Palliative Surgery? [Elektronische Daten] [Paul Mosca, Dan Blazer III, Jane Wheeler, Amy Abernethy] In the context of healthcare reform, Surgery stands at a critical juncture. Attempting to rein in healthcare spending, legislators and payers can be expected to closely examine the legitimacy and necessity of a variety of medical treatments, including surgical procedures. Among these procedures, the most at risk for dismissal based on perceived ineffectiveness or lack of need may be those performed near the end of life, when the potential benefit of surgical intervention may seem negligible. While procedures may be performed for a variety of reasons toward the end of life—some indeed being inappropriate and/or unnecessary—palliative surgery plays an important role in the management of incurable disease. The purposes of this article are to: describe the place for palliative surgery in the armamentarium of palliative care; discuss potential challenges to patients' access to palliative surgery that may arise from health policy or quality initiatives based on poor evidence; and outline a strategy for (a) systematically differentiating palliative surgeries from other, potentially expendable surgeries performed near the end of life, and (b) defining a plan for generating the evidence base to support best practice. Society of Surgical Oncology, 2011 Mosca Paul Division of Surgical Oncology, Department of Surgery, Duke University Medical Center, 27710, Durham, NC, USA aut Blazer III Dan Division of Surgical Oncology, Department of Surgery, Duke University Medical Center, 27710, Durham, NC, USA aut Wheeler Jane Division of Medical Oncology, Duke University Medical Center, 27710, Durham, NC, USA aut Abernethy Amy Division of Medical Oncology, Duke University Medical Center, 27710, Durham, NC, USA aut Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3235-3239 1068-9265 18:12<3235 2011 18 10434 https://doi.org/10.1245/s10434-011-1787-z text/html Onlinezugriff via DOI 1 editorial jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1787-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mosca Paul Division of Surgical Oncology, Department of Surgery, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Blazer III Dan Division of Surgical Oncology, Department of Surgery, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Wheeler Jane Division of Medical Oncology, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Abernethy Amy Division of Medical Oncology, Duke University Medical Center, 27710, Durham, NC, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3235-3239 1068-9265 18:12<3235 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer