Discussion
upper GI cancers
UPPER GI CANCER, METASTATIC DISEASE
To our knowledge, this is the first multisite randomized clinical trial of palliative care in a surgery patient population and includes the earliest reported integration of palliative care in oncologic care. Despite previously discussed surgical cultural barriers to palliative care, this study was completed without any reported palliative care–related harms and was well received by both patients and participating surgeons. Our results do not support that early integration of palliative care among patients with upper GI cancers pursuing curative-intent surgeries improves patient-reported HRQOL or mood symptoms.Studies support that early integration of palliative care improves patient-reported HRQOL and mood symptoms, particularly among medical oncology patients with metastatic disease with little chance of cure.Existing data support a current, widespread, persistent, and substantial shortage of palliative care specialists.