Background: Despite having disseminated cancer, not all patients are eligible for palliative chemotherapy or targeted therapies.
Aim: To study reasons for withholding palliative chemotherapy, to survey which alternatives were offered and to study survival outcomes.
Materials And Methods: Medical records of 346 patients with disseminated cancer were collected. Univariate and multivariate statistics were applied.
Results: In total, 48% (n=164) of patients were not offered palliative chemotherapy, mainly depending on diagnosis, age and performance status. Instead, palliative radiotherapy (44%) or endocrine treatments (25%) (breast and prostate cancer) were prescribed. The mean survival for these patients was 216 days, with median survival of only 77 days. In the Cox multivariate analysis survival, prospects were better if the patient was ambulatory and living at home at the first consultation (p<0.01), if performance status was acceptable (p<0.01) and if endocrine treatment was an option (p<0.05).
Conclusion: The prognosis is quite variable, even in cases where palliative chemotherapy is not an option. A hormone-sensitive tumour and a good performance status are significant factors affecting survival in this patient group.
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World J Gastroenterol
December 2024
Diagnostic and Molecular Pathology, The Ottawa Hospital and University of Ottawa, Ottawa K1H 8L6, Ontario, Canada.
Small cell lung carcinoma metastatic to the stomach, whether synchronous or metachronous, is a rare phenomenon accounting for < 0.5% of lung cancers. Hence it can be overlooked by clinicians resulting in delayed diagnosis.
View Article and Find Full Text PDFWorld J Gastrointest Surg
December 2024
Department of Oncology, Suzhou Ninth People's Hospital, Suzhou 215200, Jiangsu Province, China.
Background: Surgical palliative surgery is a common method for treating patients with middle and late stage gastrointestinal tumors. However, these patients generally experience high levels of cancer pain, which can in turn stimulate the body's stress and undermine the effect of external surgery. Although opioid drugs have a significantly positive effect on controlling cancer pain, they can induce adverse drug reactions and potential damage to the body 's immune function.
View Article and Find Full Text PDFBMC Cancer
December 2024
Department of Obstetrics and Gynecology, Institution of Women's Medical Life Science, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Korea.
Objective: This study aimed to identify the recurrence and survival rates according to the mismatch repair (MMR), p53, and L1 cell adhesion molecule (L1CAM) status in patients with advanced and recurrent endometrial cancer (EC) receiving systemic chemotherapy.
Methods: This single-center retrospective cohort study included chemotherapy-naïve patients with advanced-stage (III/IV) or recurrent EC between January 2015 and June 2022 (n = 156), who were administered chemotherapy as adjuvant therapy or first-line palliative treatment. MMR and p53 status were assessed, and L1CAM was tested using immunohistochemistry in the p53-wild and MMR-proficient (p53wt/pMMR) group.
BMC Palliat Care
December 2024
The Palliative Care Center, Päijät-Häme Wellbeing Services County, Lahti, Finland.
Background: Studies show that hospital deaths bring significant health care costs, and the involvement of specialized palliative care can help to reduce these costs. The aim of this retrospective registry-based study was to evaluate end-of-life hospital costs in patients dying in a university hospital oncology ward, with or without specialized palliative outpatient clinic contact at any timepoint.
Methods: The study population consists of all patients who died in the Kuopio University Hospital oncology ward in the years 2012-2018 (n = 457).
BMC Med Res Methodol
December 2024
Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.
Background: The aim of this study is to develop a method we call "cost mining" to unravel cost variation and identify cost drivers by modelling integrated patient pathways from primary care to the palliative care setting. This approach fills an urgent need to quantify financial strains on healthcare systems, particularly for colorectal cancer, which is the most expensive cancer in Australia, and the second most expensive cancer globally.
Methods: We developed and published a customized algorithm that dynamically estimates and visualizes the mean, minimum, and total costs of care at the patient level, by aggregating activity-based healthcare system costs (e.
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