Journal of Clinical Oncology, 2005 ASCO Annual Meeting Proceedings.
Vol 23, No 16S (June 1 Supplement), 2005: 8076
© 2005 American Society of Clinical Oncology

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Abstract

Palliative care in oncology. An analysis of a cohort of 656 patients followed up to the end of life

Inst Oncologico Henry Moore (IOHM), Buenos Aires, Argentina; Inst William Osler de Patologías Especiales, Buenos Aires, Argentina

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Background: Despite comprehensive palliative care programs have been successfully implemented in developed countries, there is less information from developing ones such as Argentina, and we aimed to analyze the results of a palliative care program that is integrated with oncological care at the IOHM. Methods: A retrospective evaluation of the clinical records of all adult patients referred to our program between 1998 and 2004 and followed up from diagnosis to death at our center was made. Characteristics of population: Six hundred and fifty nine patients (mean age 61 years, range 18 to 97, F=342, M=314) were included. Gastrointestinal tumors (23%), breast (17%) and lung (16%) were the most frequent diagnoses in this cohort. Treatment: One hundred and eighty (27%) required at least one palliative surgical procedure (i.e. paracentesis, pleurodesis, colostomy, nephrostomy) and 108 (16.5%) received palliative radiotherapy mainly for pain relief or for CNS metastasis. Seventy five percent of the patients received pain medication: NSD only: 19 (3.9%) and opiates: 472 (87.3%). Three hundred and ninety patients (60%) received chronic steroids, 77 (12%) needed oxygen supplementation, 49 (7.5%) required antibiotics, 22 patients (3,3%) needed anticoagulation and 25 (3,8%), antidepressants. Results: All patients eventually died because of disease progression at a median of 33 months after diagnosis. The median survival from the inclusion to the program was 2 months (range 0.5 to 16). Three hundred ninety two (60%) patients died hospitalized after a median of 15 days of admission. Conclusions: Our comprehensive program for palliative care of terminally ill cancer patients successfully provided ambulatory and home care. Despite this efforts more than 50% of the patients die in hospitals, but the length of internation has been reduced to a median of 15 days. It correlates with similar results for terminal care in USA (Foley K, NEJM 336:53–58. 1997) Improvements for quality of life and cost savings is obvius.

No significant financial relationships to disclose.

Abstract presentation from the 2005 ASCO Annual Meeting