Brazilian Society of Surgical Oncology: Realities and challenges of surgical oncologists in palliative care practice.

Abstract

e13553 Background: Palliative care (PC) enhances symptom control, quality of life (QoL), and decision-making in oncology. Despite its relevance to surgical oncology (SO), research on surgeon´s perceptions and practices is limited. This study surveyed members of the Brazilian Society of Surgical Oncology (SBCO) to assess their perceptions, practices, and barriers related to PC in surgical oncology. Methods: A 25-question SurveyMonkey survey was distributed to SBCO members (September–December 2024). It evaluated formal training, PC practices, and integration into SO. Responses were confidential, and group differences were analyzed using Fisher's exact and chi-square tests. Results: Among 184 respondents (response rate: 18.4%), most were aged 30–50 years (76.7%) and were male (69.6%). A majority (70.7%) worked in the South or Southeast regions of Brazil, and 87.4% primarily treated gastrointestinal, gynecological, or skin tumors. All respondents acknowledged the importance of PC, but 91.9% reported limited formal training, and 69.6% had infrequent participation in PC courses. Notably, 95.7% supported integrating PC education into surgical training programs. Although 93% expressed moderate to high confidence in managing PC, and 97.2% emphasized patient preferences and 55% reported access to PC in specialized services. Early integration of PC into surgical planning was supported by 76.6%, and 89.6believed team collaboration improves outcomes. For palliative surgeries, 61.4% cited concerns about efficacy and postoperative QoL, 25% mentioned patient or family expectations, and 13.6% cited risks of complications. Most (78.8%) felt confident discussing surgical options, and 69.6% were comfortable addressing prognostic information. However, discomfort with palliative surgeries was higher among those aged 50 or older respondents (14.6% vs. 5.6%). Barriers included resource limitations (37.5%), insufficient training (27.7%), communication challenges (21.7%), and ethical issues (11.4%). Pain management (71.2%), psychological support (15.8%), nutritional support (9.2%), and complementary therapies (3.8%) were prioritized QoL interventions. No significant differences were observed between public and private healthcare systems regarding perceptions or practices. Conclusions: Surgical oncologists recognize the importance of palliative care, including its early integration into surgical planning, and emphasize the need for training to address barriers and optimize care goals in both public and private services.