Table 4

Responses to individual case scenarios by practice type

TotalSurgical oncologistsAcute care surgeonsP value
Case 1: a 50-year-old man with colon cancer 36 months from resection and adjuvant chemotherapy with a single point of obstruction in the terminal ileum. He has a single, 3 cm metastatic lesion in his liver, but no other metastatic disease.
 Base scenario94.94 (4.70±0.64)95.80 (4.83±0.48)94.42 (4.62±0.71)0.587
 Multiple hepatic metastases82.91 (4.16±0.97)91.60 (4.48±0.72)77.66 (3.97±1.04)0.001
 Pulmonary metastases71.84 (3.87±1.16)84.87 (4.31±0.83)63.96 (3.60±1.24)<0.001
 Shorter disease-free interval86.08 (4.29±0.84)87.39 (4.39±0.78)85.28 (4.23±0.87)0.599
 Omental metastases63.92 (3.68±1.11)78.15 (4.05±0.95)55.33 (3.46±1.15)<0.001
 Pancreatic adenocarcinoma46.84 (3.22±1.24)47.06 (3.24±1.22)46.70 (3.22±1.26)0.951
Case 2: a 45-year-old woman with epithelial ovarian cancer 36 months from optimal debulking and adjuvant chemotherapy with a single point of obstruction in the small bowel from carcinomatosis. She has three peritoneal implants, but no other metastatic disease.
 Base scenario74.48 (3.97±1.12)90.18 (4.29±0.86)64.61 (3.60±1.19)<0.001
 Ascites present57.24 (3.41±1.19)74.11 (3.81±1.04)46.63 (3.16±1.21)<0.001
 Multiple areas of obstruction22.76 (2.54±1.17)26.79 (2.65±1.13)20.22 (2.48±1.18)0.194
 2nd episode of obstruction24.48 (2.63±1.14)25.00 (2.63±1.07)24.16 (2.65±1.18)0.871
 Shorter disease-free interval47.59 (3.24±1.13)50.00 (3.29±1.03)46.07 (3.22±1.18)0.514
 Melanoma73.10 (3.88±1.15)87.50 (4.27±0.99)64.04 (3.63±1.19)<0.001
Case 3: a 62-year-old woman with a carcinoid tumor 48 months from resection of an isolated mesenteric mass with a single point of obstruction in the jejunum from an unresectable central mesenteric mass.
 Base scenario83.88 (4.21±0.93)90.99 (4.50±0.74)79.01 (4.01±0.99)0.008
 Stable hepatic metastases75.09 (3.94±1.00)87.39 (4.33±0.81)66.67 (3.67±1.03)<0.001
 2nd episode of obstruction44.69 (3.22±1.11)54.95 (3.41±1.03)37.65 (3.08±1.15)0.005
 Shorter disease-free interval32.97 (2.82±1.23)36.94 (2.91±1.25)30.25 (2.76±1.21)0.248
 Multiple areas of obstruction32.60 (2.90±1.15)39.64 (3.09±1.12)27.78 (2.78±1.15)0.04
  • All patients were described as being otherwise healthy with good functional status. Patients had no signs of peritonitis or other indications for emergent surgery, although participants were informed that the obstruction would not resolve with conservative management. Responses reported as percent responding ‘likely’ or ‘very likely’ to offer an operation (mean response on the 5-point Likert scale±SD). Full case scenarios are shown in online supplemental file 1.