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. 2022 Sep 23;12(10):1565.
doi: 10.3390/jpm12101565.

Neurosurgical Defeats: Critically Ill Patients and the Role of Palliative Care Service

Quintino Giorgio D'Alessandris  1 , Maria Adelaide Ricciotti  2 , Davide Palombi  1 , Ludovico Agostini  1 , Pier Paolo Mattogno  1 , Giuseppe Maria Della Pepa  1 , Alessio Albanese  1 , Silvia Chiesa  3 , Sabrina Dispenza  2 , Eleonora Meloni  2 , Anita Maria Tummolo  2 , Roberto Pallini  1 , Christian Barillaro  2 , Alessandro Olivi  1 , Liverana Lauretti  1
Affiliations

Neurosurgical Defeats: Critically Ill Patients and the Role of Palliative Care Service

Quintino Giorgio D'Alessandris et al. J Pers Med. .

Abstract

The onco-functional balance in neuro-oncology requires maximizing tumor removal while rigorously preserving patients' neurological status. When postoperative worsening prevents the implementation of oncologic treatments, palliative care service offers an individualized path for symptom and psychosocial distress relief. Here, we report on a series of 25 patients operated on for malignant brain tumor who did not undergo adjuvant treatments after neurosurgery; they represented 3.9% of the whole institutional surgical series. These patients were significantly older and had a lower preoperative Karnofsky performance status than the whole cohort. Importantly, in 22 out of 25 (88%) cases, a surgical complication occurred, leading to clinical worsening in 21 patients. For the end of life, the majority of patients chose a hospice care facility (72%). While a careful selection of brain tumor patients candidate to neurosurgery is required, palliative care service provided invaluable help in coping with patients' and caregivers' needs.

Keywords: brain tumor; multidisciplinary tumor board; neurosurgery; palliative care; performance status.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart.
See this image and copyright information in PMC

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