End-of-life care among patients with pancreatic cancer with or without palliative intervention: a retrospective single-centre study

Abstract

Introduction: Palliative care can reduce the symptom burden and may increase the life expectancy for patients with advanced malignancies. The aim of this study was to evaluate the impact of palliative intervention on the treatment procedures for pancreatic cancer patients during their last month of life. Material and Methods: This retrospective single-centre study included adult pancreatic cancer patients who were treated in Turku University Hospital during their last month of life and died between 2011 and 2016. Data were collected from hospital database. Oncological treatments, the number of radiological examinations and procedures, surgical procedures, emergency department visits, hospitalisations, the place of death and medical costs were examined in tertiary care for patients with or without contact to the palliative care unit. Results: From 378 eligible patients, 20% (n = 76) had a contact to the palliative care unit. These patients had less radiological examinations (p < 0.0001), hospitalisations (p <0.0001) and emergency department visits (p = 0.021) during the last month of life. They did not die in the university hospital as often (p = 0.011) and median of their medical costs during the last month of life was approximately half (p <0.0001) when compared to patients with no palliative intervention (n = 302). They had longer overall survival (p <0.0001) which was the only difference detected in the characteristics of the groups. Conclusion: Fewer treatment procedures and lower tertiary care costs during the last month of life were observed for the pancreatic cancer patients who had a contact to the palliative care unit. Palliative care intervention should be an essential part of the treatment schedule for these patients.