A randomized trial of a specialist palliative care intervention for patients undergoing surgery for cancer: rationale and design of the Surgery for Cancer with Option of Palliative Care Expert (SCOPE) Trial

Trials. 2019 Dec 11;20(1):713. doi: 10.1186/s13063-019-3754-0.

Abstract

Background: In medical oncology settings, early specialist palliative care interventions have demonstrated improvements in patient quality of life and survival compared with usual oncologic care. However, the effect of early specialist palliative care interventions in surgical oncology settings is not well studied.

Methods: The Surgery for Cancer with Option for Palliative Care Expert (SCOPE) Trial is a single-center, prospective, single-blind, randomized controlled trial of a specialist palliative care intervention for cancer patients undergoing non-palliative surgery. It will enroll 236 patients scheduled for major abdominal operations for malignancy, who will be randomized 1:1 at enrollment to receive usual care (control arm) or specialist palliative care consultation (intervention arm). Intervention arm patients will receive consultations from a palliative care specialist (physician or nurse practitioner) preoperatively and postoperatively. The primary outcome is physical and functional wellbeing at 90 days postoperatively. Secondary outcomes are quality of life at 90 days postoperatively, posttraumatic stress disorder symptoms at 180 days postoperatively, days alive at home without an emergency room visit in the first 90 postoperative days, and overall survival at 1 year postoperatively. Participants will be followed for 3 years after surgery for exploratory analyses of their ongoing quality of life, healthcare utilization, and mortality.

Discussion: SCOPE is an ongoing randomized controlled trial evaluating specialist palliative care interventions for cancer patients undergoing non-palliative oncologic surgery. Findings from the study will inform ways to identify and improve care of surgical patients who will likely benefit from specialist palliative care services.

Trial registration: ClinicalTrials.gov Identifier: NCT03436290 First Registered: 16 February 2018 Enrollment Began: 1 March 2018 Last Update: 20 December 2018.

Keywords: Cancer; Palliative care; Randomized controlled trials; Surgical oncology; Trial protocol.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Cystectomy* / adverse effects
  • Cytoreduction Surgical Procedures* / adverse effects
  • Digestive System Surgical Procedures* / adverse effects
  • Female
  • Health Status
  • Humans
  • Male
  • Mental Health
  • Neoplasms / diagnosis
  • Neoplasms / psychology
  • Neoplasms / surgery*
  • Palliative Care*
  • Perioperative Care*
  • Prospective Studies
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Single-Blind Method
  • Tennessee
  • Time Factors
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT03436290