ImportanceComplex cancer procedures are now performed in the ambulatory surgery setting. Remote symptom monitoring (RSM) with electronic patient-reported outcomes (ePROs) can identify patients at risk for acute hospital encounters. Defining normal recovery is needed to set patient expectations and optimize clinical team responses to manage evolving problems in real time.ObjectiveTo describe the patterns of postoperative recovery among patients undergoing ambulatory cancer surgery with RSM using an ePRO platform—the Recovery Tracker.Design, Setting, and ParticipantsIn this retrospective cohort study, patients who underwent 1 of 5 of the most common procedures (prostatectomy, nephrectomy, mastectomy, hysterectomy, or thyroidectomy) at the Josie Robertson Surgery Center at Memorial Sloan Kettering Cancer Center from September 2016 to June 2022. Patients completed the Recovery Tracker, a brief ePRO platform assessing symptoms for 10 days after surgery. Data were analyzed from September 2022 to May 2023.Main Outcomes and MeasuresSymptom severity and interference were estimated by postoperative day and procedure.ResultsA total of 12 433 patients were assigned 110 936 surveys. Of these patients, 7874 (63%) were female, and the median (IQR) age at surgery was 57 (47-65) years. The survey response rate was 87% (10 814 patients responding to at least 1 of 10 daily surveys). Among patients who submitted at least 1 survey, the median (IQR) number of surveys submitted was 7 (4-8), and each assessment took a median (IQR) of 1.7 (1.2-2.5) minutes to complete. Symptom burden was modest in this population, with the highest severity on postoperative days 1 to 3. Pain was moderate initially and steadily improved. Fatigue was reported by 6120 patients (57%) but was rarely severe. Maximum pain and fatigue responses (very severe) were reported by 324 of 10 814 patients (3%) and 106 of 10 814 patients (1%), respectively. The maximum pain severity (severe or very severe) was highest after nephrectomy (92 of 332 [28%]), followed by mastectomy with reconstruction (817 of 3322 [25%]) and prostatectomy (744 of 3543 [21%]). Nausea (occasionally, frequently, or almost constantly) was common and experienced on multiple days by 1485 of 9300 patients (16%), but vomiting was less common (139 of 10 812 [1%]). Temperature higher than 38 °C was reported by 740 of 10 812 (7%). Severe or very severe shortness of breath was reported by 125 of 10 813 (1%).Conclusions and RelevanceDefining detailed postoperative symptom burden through this analysis provides valuable data to inform further implementation and maintenance of RSM programs in surgical oncology patients. These data can enhance patient education, set expectations, and support research to allow iterative improvement of clinical care based on the patient-reported experience after discharge.

中文翻译：

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门诊癌症手术后患者电子报告症状

重要性复杂的癌症手术现在在门诊手术环境中进行。远程症状监测 (RSM) 和电子患者报告结果 (ePRO) 可以识别有急性住院风险的患者。需要定义正常恢复，以设定患者期望并优化临床团队响应，以实时管理不断变化的问题。目的描述使用 ePRO 平台（恢复跟踪器）接受 RSM 门诊癌症手术的患者术后恢复模式。设计、设置、和参与者在这项回顾性队列研究中，患者于 2016 年 9 月至 2022 年 6 月在纪念斯隆凯特琳癌症中心的乔西·罗伯逊手术中心接受了 5 种最常见手术（前列腺切除术、肾切除术、乳房切除术、子宫切除术或甲状腺切除术）中的一种。完成了恢复追踪器，这是一个简短的 ePRO 平台，用于评估手术后 10 天的症状。分析了 2022 年 9 月至 2023 年 5 月的数据。主要结果和措施通过术后天数和手术来估计症状严重程度和干扰。结果共有 12 433 名患者接受了 110 936 项调查。这些患者中，7874 名 (63%) 为女性，手术时中位 (IQR) 年龄为 57 (47-65) 岁。调查回复率为 87%（10 814 名患者至少回复 10 项每日调查中的 1 项）。在至少提交 1 项调查的患者中，提交的调查数量中位数 (IQR) 为 7 (4-8)，每项评估的完成时间中位数 (IQR) 为 1.7 (1.2-2.5) 分钟。该人群的症状负担较轻，术后第 1 至 3 天最严重。疼痛最初为中度，随后逐渐改善。6120 名患者 (57%) 报告出现疲劳，但很少很严重。10 814 名患者中的 324 名 (3%) 和 10 814 名患者中的 106 名 (1%) 分别报告了最大疼痛和疲劳反应（非常严重）。肾切除术后的最大疼痛严重程度（严重或非常严重）最高（332 例中的 92 例 [28%]），其次是乳房切除术重建（3322 例中的 817 例 [25%]）和前列腺切除术（3543 例中的 744 例 [21%]）。恶心（偶尔、频繁或几乎持续）很常见，并且 9,300 名患者中的 1,485 名患者 (16%) 连续多天出现恶心，但呕吐不太常见（10 812 名患者中的 139 名 [1%]）。10 812 人中有 740 人 (7%) 报告体温高于 38 °C。10 813 名患者中，有 125 名 (1%) 报告有严重或非常严重的呼吸短促。结论和相关性通过此分析定义详细的术后症状负担，可以提供有价值的数据，为肿瘤外科患者进一步实施和维护 RSM 计划提供信息。这些数据可以加强患者教育、设定期望并支持研究，以便根据出院后患者报告的经历迭代改进临床护理。