What Defines the Value of Minimally Invasive Surgery for Cancer Patients?

With the evolution of value-based health care for cancer patients in the United States, it is critical that value measurements accurately reflect patients’ perspectives.^1‐3 Our previous survey study described remarkable discordance between physicians and cancer patients in the perception of the value of health care, and such perception changes over time.⁴ Physicians must understand what aspects of health care are important for cancer patients to enable patient-centered cancer care. In particular, the use of minimally invasive surgery (MIS) for cancer has increased, but what defines the value of MIS from patients’ perspectives is not known. For example, shorter length of stay has been considered one of the primary clinical benefits of MIS and was defined as a primary outcome in studies to prove the benefits of MIS for pancreatic and gastric cancers.^5,6 However, it is questionable whether patients undergoing a once-in-a-lifetime cancer operation care about a day or two longer in the hospital or the length of incisions. Better understanding of patients’ perception of the relative importance of metrics of surgery is needed to help guide patient-centered, value-based surgical care and research for patients with cancer who may receive MIS approaches. We investigated the importance patients place on various value metrics by conducting a value survey study for patients who underwent major pancreatectomy or gastrectomy for cancer. …