Pediatric Palliative Surgical Oncology: Principles, Practice, and Evolving Roles.

Pediatric cancer care has changed dramatically over the past several decades, with survival rates increasing to nearly 85% across many childhood malignancies. Yet, despite these advances, children with cancer and their families continue to confront significant physical, emotional, and psychosocial burdens. The expanding role of surgery in both curative and noncurative contexts demands proficiency in operative skill and also in communication, shared decision-making, prognostication, and the delivery of primary palliative care. This article presents a comprehensive, evidence-informed framework for pediatric palliative surgical oncology. We discuss the current literature, guiding principles, and communication models, and ethical complexities unique to pediatric patients.