In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 31_suppl ( 2017-11-01), p. 153-153
Abstract:
153 Background: Five year overall survival rate for localized and metastatic pancreatic adenocarcinoma (PAC) is discouraging at 31.5% and 2.7%, respectively. Evidence supports that early palliative care (PC) involvement leads to better quality of life and prolongs OS. Referral to PC is often delayed as it is perceived as an alternative rather than adjunctive care. We conducted a retrospective study to identify different variables that affect PC consultation among patients (pts) with PAC admitted to the hospital and to study the impact of health care utilizations on OS. Methods: A retrospective medical record review of pts with PAC diagnosed/treated at SUNY Upstate University hospital was conducted (2011-2015). Variables like age, sex, race, stage at diagnosis, insurance status, performance status (PS), frequency of hospital admissions, nights spent, procedure visits, blood products used, and time variable to PC referral from diagnosis were collected. OS was calculated using Kaplan Meier analysis. Results: We identified 325 pts with diagnosis of PAC. 86.72% pts had one or more hospital admissions during course of their illness and of these, 15.85% saw PC during initial inpatient admission. 36.23% saw PC later in the course of their illness and 13.96% pts were offered palliative care in first outpatient visit. Median time interval to see palliative care was 75 days (d) from diagnosis, with 25% pts seeing PC 304d from diagnosis. Variables that had significant impact on early palliative care encounter (0-30d) were age 〉 70, stage IV at diagnosis, PS of 4, medicare insurance, offered PC in first visit (p 〈 0.001). OS was not statistically significant between groups who had ≥ 1 vs 0 blood products given, 〈 3 vs ≥ 3 hospital admissions, ≤ 13 vs 〉 13 nights spent, ≥ 1 vs 0 procedures done, ≤ 3 vs 〉 3 consults service seen. Median OS for pts with time interval to see PC 0-30d vs 〉 120d was 33d and 510d respectively with adjusted hazard ratio of 6.252 (95% CI 3.462-11.29). Conclusions: We demonstrated that PC is underutilized with only minority of pts benefiting from it during their cancer treatment. OS was poor in group evaluated by palliative care early than late which could be due to patients with advanced disease and poor PS being referred early.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2017.35.31_suppl.153
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2017
detail.hit.zdb_id:
2005181-5
