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Association of palliative care management and survival after chemotherapy discontinuation in patients with advanced pancreatic adenocarcinoma: A retrospective single-centre observational study.
Brugel, M; Dupont, M; Carlier, C; Botsen, D; Essi, D Edoh; Sanchez, V; Slimano, F; Perrier, M; Bouché, O.
Afiliación
  • Brugel M; Université de Reims Champagne-Ardenne, Department of Ambulatory Oncology Care Unit, CHU Reims, Reims, France. Electronic address: mathias.brugel22@imperial.ac.uk.
  • Dupont M; Department of Medical Oncology, Institut Jean Godinot, Reims, France.
  • Carlier C; Université de Reims Champagne-Ardenne, Department of Ambulatory Oncology Care Unit, CHU Reims, Reims, France; Department of Medical Oncology, Institut Jean Godinot, Reims, France.
  • Botsen D; Université de Reims Champagne-Ardenne, Department of Ambulatory Oncology Care Unit, CHU Reims, Reims, France; Department of Medical Oncology, Institut Jean Godinot, Reims, France.
  • Essi DE; Department of Medical Oncology, Institut Jean Godinot, Reims, France.
  • Sanchez V; Department of Palliative Care, CHU Reims, Reims, France.
  • Slimano F; Université de Reims Champagne-Ardenne, Department of Pharmacy, CHU Reims, Reims, France.
  • Perrier M; Université de Reims Champagne-Ardenne, Department of Ambulatory Oncology Care Unit, CHU Reims, Reims, France.
  • Bouché O; Université de Reims Champagne-Ardenne, Department of Ambulatory Oncology Care Unit, CHU Reims, Reims, France.
Pancreatology ; 23(4): 403-410, 2023 Jun.
Article en En | MEDLINE | ID: mdl-37037682
BACKGROUND: Palliative care (PC) is integrated into standard oncology care. However, its clinical impact at the end of life remains unclear in pancreatic adenocarcinoma (PA). We aimed to describe the end-of-life care pathway and to assess whether PC referral influences survival after chemotherapy discontinuation (CD) among advanced PA patients. METHODS: This retrospective single-centre observational study was conducted among deceased patients with advanced PA who had received chemotherapy between January 1, 2016, and December 31, 2021. Baseline characteristics, the timing of PC referral and events after CD were collected. The primary outcome was time from CD to death. RESULTS: Among the 148 included patients, 53.4% (n = 79) received PC, mostly late after the CD (n = 133, 89.9%), 16.9% (n = 25) received chemotherapy in the last 14 days of life and 75.6% died at the hospital. None received PC in the 8 weeks following the diagnosis. PC referral significantly increased PC department admissions (p < 0.001) and decreased medical unit admissions (p < 0.001). The median survival after the CD was 35 days (IQR: 19-64.5). PC referral was associated with increased survival after CD (HR: 0.65 [0.47-0.90], p = 0.010, Cox) and after adjusting (HR: 0.65 [0.42-0.99], p = 0.045, Cox). CONCLUSION: The study suggests that PC may be associated with longer survival after CD in advanced PA patients. However, PC is underused, and patients are referred late in their care pathway.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pancreáticas / Adenocarcinoma / Neoplasias Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Pancreatology Asunto de la revista: ENDOCRINOLOGIA / GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Suiza
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pancreáticas / Adenocarcinoma / Neoplasias Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Pancreatology Asunto de la revista: ENDOCRINOLOGIA / GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Suiza