Comment on: “Postoperative Discomforts and Patient Satisfaction Following Anesthesia in Gynecological Oncology Surgery: An Observational Study”

Dear Editor, In the recent issue of the Bali Journal of Anesthesiology, Solanki et al.[1] meticulously investigated the patient-reported outcome measures (PROMs) in the setting of an elective gynecological oncology surgery. The observational study indeed features at an opportune time, denoting the much-needed evolution from a unidimensional research focus on the pain score assessment to addressing patient-centered postoperative recovery.[2] We, however, wish to present our reflections on the index study to stimulate a thought-provoking discussion on this subject of growing clinical interest. First and foremost, any research endeavor focusing on PROMs can be rendered more robust when backed by a sound baseline risk-profiling of the preoperative patient population. In this regard, preoperative quality of sleep and anxiety are important predictors of not only pain but also overall recovery following gynecologic oncology surgery.[3] Whereas a considerable 35.6% of the subjects studied go on to report anxiety as the most distressing facet of the overall surgical experience, the preoperative anxiety can be specifically ameliorated with education and counseling.[1] Second, the allied risk of outcomes such as postoperative nausea and vomiting could have been better accounted for with the inclusion of a formal scoring system, such as the Apfel score.[4] This becomes particularly important given an exclusively female patient sex under evaluation, wherein presentation of factors like a nonsmoker status could have contributed to contextual lucidity.[4] To that end, clarification needs to be sought from the authors on whether the entire patient cohort underwent an open surgical procedure or included laparoscopic procedures as well. Finally, it is humbly suggested that the oncological research settings could be served well by the reporting of the predisposing factors, such as preoperative patient frailty and pre-frailty status.[1,5] The importance of the former is nested in the intriguing combination of frailty and oncology, rendering even the younger cancer patients vulnerable.[5] Data availability statement No new data are processed for this manuscript. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.