Brazilian Society of Surgical Oncology: Guidelines and Consensus Statement for Palliative Surgery in Oncology

BACKGROUND AND OBJECTIVE: Palliative surgery in oncology aims to relieve symptoms, improve quality of life, and respect patient autonomy in advanced cancer. This study aimed to develop evidence-based recommendations for safely indicating and performing palliative surgeries in Brazil, considering clinical, ethical, and multidisciplinary aspects. METHODS: A modified Delphi consensus was conducted with nine experts from the Brazilian Society of Surgical Oncology, including surgical and clinical oncologists, palliative care specialists, and a psychologist. Sixteen key recommendations were formulated based on literature review and a national survey identifying gaps in training, communication, and technical safety. Consensus was defined as ≥ 80% agreement, achieved in a single round. RESULTS: Recommendations emphasize individualized patient selection based on functional status, frailty, prognosis, and symptom severity. Multidisciplinary evaluation, shared decision-making, clear communication, and consideration of minimally invasive techniques were prioritized. Palliative procedures focus on symptom control rather than survival extension, with evidence supporting improved quality of life, reduced hospital admissions, and enhanced oral intake. CONCLUSIONS: Palliative surgery should be guided by strict clinical criteria, multidisciplinary planning, and patient-centered communication. Active patient participation, ethical deliberation, and evidence-based practices ensure safe, effective, and humanized care, avoiding futile or disproportionate interventions.