Patterns of palliative care referral in ovarian cancer: A single institution 5â¯year retrospective analysis.
Gynecol Oncol
; 148(3): 521-526, 2018 03.
Article
en En
| MEDLINE
| ID: mdl-29395315
ABSTRACT
BACKGROUND:
The American Society of Clinical Oncology recommends that patients with advanced cancer receive dedicated palliative care services early in their disease course. This investigation serves to understand how palliative care services are utilized for ovarian cancer patients in a tertiary referral center.METHODS:
We conducted a retrospective review of women treated for ovarian cancer at our institution from 2010 through 2015. Clinical variables included presence and timing of palliative care referral. Data were correlated utilizing univariable and multivariable parametric and non-parametric testing, and survivals were analyzed using the Kaplan-Meier method and cox-proportional hazard models.RESULTS:
We identified 391 women treated for ovarian cancer, of whom 68% were diagnosed with stage III or IV disease. Palliative care referral was utilized in 28% in the outpatient (42%) and inpatient (58%) settings. Earlier use of referral was observed in those who never underwent surgical cytoreduction or had interval cytoreductive surgery (pâ¯<â¯0.001). Palliative care referral was independently associated with advanced stage (OR 1.7, pâ¯=â¯0.02), recurrence (OR 2.0, pâ¯=â¯0.002) and hospice referral (OR 6.0, pâ¯<â¯0.001). In 38% of women referral occurred within 30â¯days of death, and 17% within one week of death. Outpatient initial consultation was associated with an unadjusted 1â¯year overall survival benefit (pâ¯<â¯0.01) compared to inpatient consultation.CONCLUSIONS:
The outcomes in this study suggest a late use of palliative care that is reactionary to patient needs and not a routine component of ovarian cancer care as national guidelines recommend.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Ováricas
/
Cuidados Paliativos
/
Derivación y Consulta
/
Carcinosarcoma
/
Adenocarcinoma
/
Tumores de los Cordones Sexuales y Estroma de las Gónadas
/
Neoplasias Quísticas, Mucinosas y Serosas
/
Neoplasias de Células Germinales y Embrionarias
Tipo de estudio:
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Aged80
Idioma:
En
Revista:
Gynecol Oncol
Año:
2018
Tipo del documento:
Article
País de afiliación:
Estados Unidos