Study Design
upper GI cancers, Cancer
UPPER GI CANCER, CANCER
From October 20, 2018, to March 31, 2022, we enrolled ambulatory patients with newly diagnosed upper GI cancers in a nonblinded pragmatic randomized clinical trial to receive either surgeon-alone management (enhanced usual care) or surgeon–palliative care comanagement (intervention). The study was performed at 5 geographically diverse sites including The Johns Hopkins Hospital in Baltimore, Maryland; the Dana-Farber Cancer Institute in Boston, Massachusetts; Stanford University Medical Center in Stanford, California; the University of New Mexico Medical Center in Albuquerque; and The Ohio State University Wexner Medical Center in Columbus. Eligible patients were enrolled when scheduled for surgery and computer randomized in a 1:1 ratio in blocks of 4 and stratified by enrollment site with allocation provided at the time of randomization. Patients assigned to the intervention met either in person or via telephone with a member of an interprofessional palliative care specialist team, which consisted of board-certified palliative care physicians, advanced-practice nurses, social workers, pharmacists, and/or chaplains. Palliative care visits occurred before surgery, 1 week after surgery, and 1, 2, and 3 months after surgery, with additional visits scheduled at the discretion of the patient, surgery team, or palliative care team. The protocol (Guidelines for palliative care visits (