To examine older adults with GI cancers to determine whether claims-observed second surgical opinion (SSO) pathways, specifically SSO with same-surgeon resection versus SSO with different-surgeon resection, were differentially associated with surgical outcomes.
Approach:
Data Source: Linked Surveillance, Epidemiology, and End Results–Medicare (SEER–Medicare) files from 2000 to 2019 were used to identify older adults with GI cancers.
Study Population: Included individuals aged 66–90 years at cancer diagnosis with primary malignancies of the liver, biliary tract, pancreas, colon, and rectum/rectosigmoid.
Exposure and Covariates: Primary exposure was receipt of an SSO, defined as evaluation-and-management claims from ≥ 2 unique surgeon NPIs related to the index GI cancer.
Outcomes of Interest: Primary utilization outcome was receipt of cancer-directed resection within 6 months of diagnosis; perioperative outcomes included major complications, 90-day all-cause mortality, and 90-day unplanned readmission.
Key Findings:
SSO pathways were classified into three categories: surgery without an SSO, SSO with same-surgeon resection, and SSO with different-surgeon resection, with varying outcomes observed across these groups.
The study aimed to provide data to inform patient counseling, referral practices, and system design in GI surgical care.
Interpretation:
The study seeks to characterize differences in surgical outcomes based on whether patients proceed with the same surgeon or a different surgeon after obtaining a second opinion.
Limitations:
The study does not capture the clinical content of the SSO or the rationale for changing surgeons.
Data is limited to older adults enrolled in Medicare, which may not represent the broader population.
Conclusion:
The findings aim to enhance understanding of the impact of second surgical opinions on surgical outcomes in older adults with GI cancers.
U.S. News & World Report has recognized Dana-Farber/Boston Children’s Cancer and Blood Disorders Center as the #1 pediatric cancer program in the nation in its 2026-2027 Best Children’s Hospitals report.
