CClinicalTrials.gg
Active, not recruitingNCT03436290SCOPEUpdated Jan 28, 2026Results posted

Surgery for Cancer With Option of Palliative Care Expert

An interventional study of Palliative Care Intervention in Cancer, sponsored by Vanderbilt University Medical Center. Active, not recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-01-28.

Sponsored by Vanderbilt University Medical Center · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
236
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Frequently people diagnosed with cancer experience physical and emotional symptoms during the course of their disease. These symptoms can be very distressing to both the patient and the family members. The study doctor wants to know if the introduction of a team of clinicians that specialize in the lessening of many of these distressing symptoms may improve your overall care. This team of clinicians is called the palliative care team and they focus on ways to improve your pain and other symptom management (i.e. shortness of breath, fatigue, anxiety, etc.) and to assist you and your family in coping with the emotional, social, and spiritual issues associated with your diagnosis. The team consists of physicians, advanced practice nurses, case managers, and nurses who have been specially trained in the care of patients facing serious illness.

This research study is being done because although many people with cancer receive palliative care late in the course of their illness, the study team thinks palliative care may be more useful when it is started earlier and in this case before surgery. The main purpose of this study is to compare two types of care -usual surgery and cancer care and usual surgery and cancer care with comprehensive palliative care services to see which is better for improving the experience of patients and families with cancer.

Read the detailed description

The Surgery for Cancer with Option of Palliative Care Expert (SCOPE) Trial is an investigation that will study the effect of a palliative care implementation during the preoperative, perioperative, and postoperative phase for adults undergoing cancer surgery for selected gastrointestinal and genitourinary malignancies. SCOPE will be a single-blind, single-institution randomized controlled trial of 236 patients. Intervention arm patients will receive a preoperative outpatient specialty palliative care consultation from a palliative care provider (physician or nurse practitioner) in addition to inpatient and outpatient palliative care follow-up postoperatively. Control arm patients will receive usual care with palliative care available at the discretion of the primary treatment team (currently these patients rarely get palliative care and usually only in the last weeks of life). The central hypothesis of the SCOPE Trial is that preoperative, perioperative, and postoperative specialty palliative care will improve patient functioning and quality of life in patients undergoing resection of selected GI and GU malignancies.

02

Conditions studied

  • Cancer

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Keywords

  • Palliative Care
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

adult patients (≥18 years old) scheduled for one of the following abdominal operations with intent to provide cure or durable oncologic control of malignancy:

  1. Total or partial gastrectomy requiring anastomosis
  2. Total or partial pancreatectomy
  3. Partial hepatectomy
  4. Colectomy or proctactomy if one of the following 3 conditions is also met:

    i) patient age is 65 years or older ii) disease is metastatic iii) disease is locally invasive requiring extensive resection

  5. Radical cystectomy
  6. Pelvic exenteration
  7. Abdominal debulking for ovarian or endometrial carcinoma
  8. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Exclusion criteria

Exclusion Criteria:

  1. Non-English speaking patient
  2. Residence >150 miles away from Vanderbilt and do not visit the Nashville area regularly
  3. No telephone or otherwise unwilling/unable to complete follow-ups
  4. Prisoner
  5. Current enrollment in a study that does not allow co-enrollment or that uses a non-pharmacologic, non-procedural intervention directed at surgical or cancer care.
  6. Deaf
  7. Severe prior cognitive or neurodegenerative disorder that prevents a patient from living independently at baseline
  8. Inability to obtain informed consent from patient meeting all inclusion criteria for the following reasons:

    1. Attending surgeon refusal
    2. Patient refusal
    3. Period of time between screening patient and time of operation does not allow preoperative outpatient palliative care visit.
  9. Currently participating in palliative care or seeing a palliative care provider.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
236 participants (actual)

Study arms

  • Experimental
    Palliative Care Intervention

    Behavioral: Palliative Care Intervention

  • No intervention
    Standard of Care

Interventions

  • BehavioralPalliative Care Intervention

    These patients will receive the palliative care intervention.

05

What researchers measure

Primary outcomes

  1. Physical and Functional Quality of Life as Measured by the FACT-G TOI

    FACT-Gastric Trial Outcome Index (TOI) is an efficient summary index of physical/functional outcomes and is comprised of two subscales from the FACT-Gastric Score: the physical wellbeing subscale (7 questions) and the functional wellbeing scale (7 questions). Each question uses a 5-point Likert scale ranging from 0 (Not at all) to 4 (Very much). Total scores on the FACT-TOI range from 0-56. The higher the score, the better the quality of life.

    Time frame: 90 days after operation

Secondary outcomes

  1. Quality of Life as Measured by the FACT-G

    The FACT-G is a patient self-administered 27-item questionnaire that measures health state in cancer patients in prior 7 days, including physical, social, emotional, and functional well-being. Scoring: Five-point scale: 0 (not at all) to 4 (very much). Total score is from 0-108. The higher the score, the better quality of life (QOL).

    Time frame: 90 days after operation

  2. Days Alive at Home Without an Emergency Room Visit

    A count of all the days that the patient 1) has no emergency room visits, and 2) is not an inpatient of a hospital or other health-care facility

    Time frame: 90 days after operation

  3. Post-Traumatic Stress Disorder (PTSD) Symptoms

    Score on the PTSD Checklist-Civilian Version--a 17-item scale scored from 17-85 with higher scores indicating more PTSD symptoms

    Time frame: 180 days after operation

  4. Overall Survival

    Time frame: 1 year

Other outcomes

  1. Physical and Functional Quality of Life

    FACT-G TOI Score

    Time frame: 180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

  2. Functional Status

    Karnofsky Performance Status--a score that ranges from 0 to 100, with 100 indicating full functional status and 0 indicating death

    Time frame: 90 days, 180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

  3. Quality of Life

    FACT-G Score

    Time frame: 180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

  4. Depression

    PROMIS Depression-6 Score--A six item scale with scores from 5-30 with higher scores indicating more symptoms of depression

    Time frame: 90 days, 180 days after operation

  5. Anxiety

    PROMIS Anxiety-6 Score--A six item scale with scores from 5-30 with higher scores indicating more anxiety

    Time frame: 90 days, 180 days after operation

  6. Time to Adjuvant Therapy

    Number of days from operation until adjuvant chemotherapy or radiation is initiated

    Time frame: 90 days

  7. Satisfaction With Hospital Stay

    The answer to the following question: Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital during your stay?

    Time frame: 30 days

  8. Post-Traumatic Growth

    Post-Traumatic Growth Inventory score--a 21-item scale scored from 0-105 with higher scores indicating more growth after trauma

    Time frame: 180 days

  9. Care-Giver Burden

    Zarit Burden Interview score--a 12 item scale with score 0-48 with higher scores indicating more care-giver burden

    Time frame: 90 days, 180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

  10. Hospital Admissions

    Number of hospital admissions

    Time frame: 3 years

  11. ER Visits

    Number of visits to the emergency room

    Time frame: 3 years

  12. Employment

    Patient report of whether or not he or she is currently employed (yes/no question) and if yes, whether the employment is full-time or part-time

    Time frame: 180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

  13. Community vs. Facility Residence

    Patient report of whether he or she lives in a private residence or in a healthcare facility (i.e. assisted living, long-term care facility, nursing home, etc.)

    Time frame: 180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

  14. Size of Life Space

    Life Space Assessment Questionnaire score--a five item scale with scores from 0-120 with higher scores indicating larger life space i.e. larger area traversed during daily activities

    Time frame: 180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

  15. Length of Hospice Enrollment

    Time frame: last 30 days of life

  16. Receipt of Chemotherapy in Last 14 Days of Life

    Time frame: last 14 days of life

  17. Days at Home Without an ER Visit in Last 30 Days of Life

    Time frame: last 30 days of life

  18. Quality of End-of-life Care

    FATE-S score

    Time frame: last 30 days of life

  19. Location of Death

    Care-giver report of whether patient died in a private residence or in a healthcare facility such as a nursing home, hospital, or inpatient hospice facility

    Time frame: last 30 days of life

  20. Survival

    Time frame: 3 years

06

Results

Posted Jun 10, 2024

Participant flow

Participant flow — Overall Study
MilestonePalliative Care InterventionStandard of Care
Started118118
Completed77118
Not completed410
Withdrew: Post-randomization exclusion10
Withdrew: Death60
Withdrew: Withdrawal by subject40
Withdrew: Protocol violation300

Outcome measures

PrimaryPhysical and Functional Quality of Life as Measured by the FACT-G TOI

FACT-Gastric Trial Outcome Index (TOI) is an efficient summary index of physical/functional outcomes and is comprised of two subscales from the FACT-Gastric Score: the physical wellbeing subscale (7 questions) and the functional wellbeing scale (7 questions). Each question uses a 5-point Likert scale ranging from 0 (Not at all) to 4 (Very much). Total scores on the FACT-TOI range from 0-56. The higher the score, the better the quality of life.

Time frame:
90 days after operation
Reported as:
Median · units on a scale
Physical and Functional Quality of Life as Measured by the FACT-G TOI
units on a scalePalliative Care InterventionStandard of Care
Physical and Functional Quality of Life as Measured by the FACT-G TOI45.0 (36.2 to 50.0)45.0 (39.0 to 50.0)
SecondaryQuality of Life as Measured by the FACT-G

The FACT-G is a patient self-administered 27-item questionnaire that measures health state in cancer patients in prior 7 days, including physical, social, emotional, and functional well-being. Scoring: Five-point scale: 0 (not at all) to 4 (very much). Total score is from 0-108. The higher the score, the better quality of life (QOL).

Time frame:
90 days after operation
Reported as:
Median · units on a scale
Quality of Life as Measured by the FACT-G
units on a scalePalliative Care InterventionStandard of Care
Quality of Life as Measured by the FACT-G88.0 (72.8 to 99.0)91.0 (79.5 to 98.3)
SecondaryDays Alive at Home Without an Emergency Room Visit

A count of all the days that the patient 1) has no emergency room visits, and 2) is not an inpatient of a hospital or other health-care facility

Time frame:
90 days after operation
Reported as:
Median · days
Days Alive at Home Without an Emergency Room Visit
daysPalliative Care InterventionStandard of Care
Days Alive at Home Without an Emergency Room Visit84 (76 to 86)83 (79 to 85)
SecondaryPost-Traumatic Stress Disorder (PTSD) Symptoms

Score on the PTSD Checklist-Civilian Version--a 17-item scale scored from 17-85 with higher scores indicating more PTSD symptoms

Time frame:
180 days after operation

Results for this outcome have not been posted.

SecondaryOverall Survival
Time frame:
1 year
Reported as:
Number · proportion of patients surviving 1 year
Overall Survival
proportion of patients surviving 1 yearPalliative Care InterventionStandard of Care
Overall Survival0.83 (0.76 to 0.90)0.82 (0.75 to 0.90)
Other pre-specifiedPhysical and Functional Quality of Life

FACT-G TOI Score

Time frame:
180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

Results for this outcome have not been posted.

Other pre-specifiedFunctional Status

Karnofsky Performance Status--a score that ranges from 0 to 100, with 100 indicating full functional status and 0 indicating death

Time frame:
90 days, 180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

Results for this outcome have not been posted.

Other pre-specifiedQuality of Life

FACT-G Score

Time frame:
180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

Results for this outcome have not been posted.

Other pre-specifiedDepression

PROMIS Depression-6 Score--A six item scale with scores from 5-30 with higher scores indicating more symptoms of depression

Time frame:
90 days, 180 days after operation

Results for this outcome have not been posted.

Other pre-specifiedAnxiety

PROMIS Anxiety-6 Score--A six item scale with scores from 5-30 with higher scores indicating more anxiety

Time frame:
90 days, 180 days after operation

Results for this outcome have not been posted.

Other pre-specifiedTime to Adjuvant Therapy

Number of days from operation until adjuvant chemotherapy or radiation is initiated

Time frame:
90 days

Results for this outcome have not been posted.

Other pre-specifiedSatisfaction With Hospital Stay

The answer to the following question: Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital during your stay?

Time frame:
30 days

Results for this outcome have not been posted.

Other pre-specifiedPost-Traumatic Growth

Post-Traumatic Growth Inventory score--a 21-item scale scored from 0-105 with higher scores indicating more growth after trauma

Time frame:
180 days

Results for this outcome have not been posted.

Other pre-specifiedCare-Giver Burden

Zarit Burden Interview score--a 12 item scale with score 0-48 with higher scores indicating more care-giver burden

Time frame:
90 days, 180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

Results for this outcome have not been posted.

Other pre-specifiedHospital Admissions

Number of hospital admissions

Time frame:
3 years

Results for this outcome have not been posted.

Other pre-specifiedER Visits

Number of visits to the emergency room

Time frame:
3 years

Results for this outcome have not been posted.

Other pre-specifiedEmployment

Patient report of whether or not he or she is currently employed (yes/no question) and if yes, whether the employment is full-time or part-time

Time frame:
180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

Results for this outcome have not been posted.

Other pre-specifiedCommunity vs. Facility Residence

Patient report of whether he or she lives in a private residence or in a healthcare facility (i.e. assisted living, long-term care facility, nursing home, etc.)

Time frame:
180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

Results for this outcome have not been posted.

Other pre-specifiedSize of Life Space

Life Space Assessment Questionnaire score--a five item scale with scores from 0-120 with higher scores indicating larger life space i.e. larger area traversed during daily activities

Time frame:
180 days, 12 months, 18 months, 24 months, 30 months, 36 months after operation

Results for this outcome have not been posted.

Other pre-specifiedLength of Hospice Enrollment
Time frame:
last 30 days of life

Results for this outcome have not been posted.

Other pre-specifiedReceipt of Chemotherapy in Last 14 Days of Life
Time frame:
last 14 days of life

Results for this outcome have not been posted.

Other pre-specifiedDays at Home Without an ER Visit in Last 30 Days of Life
Time frame:
last 30 days of life

Results for this outcome have not been posted.

Other pre-specifiedQuality of End-of-life Care

FATE-S score

Time frame:
last 30 days of life

Results for this outcome have not been posted.

Other pre-specifiedLocation of Death

Care-giver report of whether patient died in a private residence or in a healthcare facility such as a nursing home, hospital, or inpatient hospice facility

Time frame:
last 30 days of life

Results for this outcome have not been posted.

Other pre-specifiedSurvival
Time frame:
3 years

Results for this outcome have not been posted.

Adverse events

Collected over 12 months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Palliative Care Intervention6/117 (5.1%)0/117 (0%)0/117 (0%)
Standard of Care4/118 (3.4%)0/118 (0%)0/118 (0%)

Baseline characteristics

Excludes one patient who was excluded after randomization

Age, Continuous
Age, Continuous(years)Palliative Care InterventionStandard of CareTotal
Median62.3 (56.6 to 69.3)66.6 (57.8 to 71.6)65 (56.8 to 71.1)
Sex: Female, Male
Sex: Female, Male(Participants)Palliative Care InterventionStandard of CareTotal
Female464894
Male7170141
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Palliative Care InterventionStandard of CareTotal
Hispanic or Latino022
Not Hispanic or Latino117116233
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Palliative Care InterventionStandard of CareTotal
American Indian or Alaska Native000
Asian101
Native Hawaiian or Other Pacific Islander000
Black or African American549
White111113224
More than one race000
Unknown or Not Reported011
Region of Enrollment
Region of Enrollment(participants)Palliative Care InterventionStandard of CareTotal
United States117118235
FACT-TOI
FACT-TOI(units on a scale)Palliative Care InterventionStandard of CareTotal
Median43.0 (34.8 to 50.0)44.0 (38.0 to 51.0)43.0 (36.0 to 50.0)
FACT-G
FACT-G(units on a scale)Palliative Care InterventionStandard of CareTotal
Median85.0 (72.9 to 94.0)87.4 (76.0 to 95.0)86.0 (74.8 to 94.6)
07

Study locations

1 site
  • Vanderbilt University Medical Center
    Nashville, Tennessee 37232, United States
08

References and documents

Publications

  • Shinall MC Jr, Martin SF, Karlekar M, Hoskins A, Morgan E, Kiehl A, Bryant P, Orun OM, Raman R, Tillman BF, Hawkins AT, Brown AJ, Bailey CE, Idrees K, Chang SS, Smith JA Jr, Tan MCB, Magge D, Penson D, Ely EW. Effects of Specialist Palliative Care for Patients Undergoing Major Abdominal Surgery for Cancer: A Randomized Clinical Trial. JAMA Surg. 2023 Jul 1;158(7):747-755. doi: 10.1001/jamasurg.2023.1396. PubMed 37163249 ↗
  • Orun OM, Shinall MC Jr, Hoskins A, Morgan E, Karlekar M, Martin SF, Ely EW, Raman R. Statistical analysis plan for the Surgery for Cancer with Option of Palliative Care Expert (SCOPE) trial: a randomized controlled trial of a specialist palliative care intervention for patients undergoing surgery for cancer. Trials. 2021 Apr 29;22(1):314. doi: 10.1186/s13063-021-05256-y. PubMed 33926535 ↗
  • Shinall MC Jr, Hoskins A, Hawkins AT, Bailey C, Brown A, Agarwal R, Duggan MC, Beskow LM, Periyakoil VS, Penson DF, Jarrett RT, Chandrasekhar R, Ely EW. A randomized trial of a specialist palliative care intervention for patients undergoing surgery for cancer: rationale and design of the Surgery for Cancer with Option of Palliative Care Expert (SCOPE) Trial. Trials. 2019 Dec 11;20(1):713. doi: 10.1186/s13063-019-3754-0. PubMed 31829237 ↗

Study documents

  • Protocol and statistical analysis plan · Nov 2, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Undecided

09

Registry details

Key details

Study ID
NCT03436290
Lead sponsor
Vanderbilt University Medical Center
Responsible party
Myrick C. Shinall, Jr., MD, PhD (Assistant Professor of Surgery, Vanderbilt University Medical Center) — Principal investigator
First posted
Feb 19, 2018
Start date
Mar 1, 2018
Primary completion
Feb 24, 2022
Completion
Nov 2026 (estimated)
Results posted
Jun 10, 2024
Last update
Jan 28, 2026

Study contacts

Myrick C Shinall, MD
principal investigator · Assistant Professor

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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