Gastroesophageal cancer patients need earlier palliative intervention - Using data to inform appropriate care

Lee, Amanda J; Khulusi, S.; Watson, Roger

doi:10.1016/j.ejon.2019.04.004

Cited by 2 publications

(5 citation statements)

References 32 publications

(23 reference statements)

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“…For example, treatment at an academic center (HR 0.90 on univariate, P = 0.047), non-black, other race compared to white race (HR 0.72 on multivariable, P = 0.011), and female gender (HR 0.81 on multivariable, P = 0.002) were significantly associated with decreased mortality in our cohort. We found sex disparities in our current study, which contrasts findings from a retrospective series of esophageal cancer patients referred to a specialist UK cancer center by 6 National Health Service sites and multiple primary care referral centers whereby there were no statistically significant differences in survival between men and women[ 30 ]. However, advancing age and socioeconomic deprivation was impaired to poorer OS in this study.…”

Section: Discussioncontrasting

confidence: 99%

“…Additionally, although the use of formal palliative care consultation was not directly investigated, integration of palliative care along with usual oncologic care is now a widely recommended approach across national practice guidelines in oncology[ 10 ]. Early initiation of palliative care and beyond the outpatient setting is important as nearly 40% of patients with gastroesophageal cancer die within the first 6 months of presentation, reflective of a population with aggressive tumors or a disease state that is too advanced for curative therapy[ 30 ]. In advanced esophageal cancer, greater implementation of this practice is certainly warranted.…”

Section: Discussionmentioning

confidence: 99%

“…Although not statistically significant, having an income quartile of > $46000 was associated with a lower HR of 1.06, while having an income quartile of $35000-$45999 annually was significantly associated with poorer survival (HR 1.21, Table 1 ) on multivariable analysis. It has been shown that the presence of modifiable risk factors such as smoking, poor diet, impaired physical activity, and increased BMI are more commonly found in socioeconomically deprived groups, which can attribute to reduced survival outcomes in multiple studies on cancer[ 30 ]. In other studies of esophageal cancer, lower socioeconomic status has been associated with poorer prognosis, while the incidence and mortality rates for esophageal cancer were higher in rural areas compared to urban areas across multiple nations[ 33 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact of palliative therapies in metastatic esophageal cancer patients not receiving chemotherapy

Kim¹,

DiPeri²,

Guan³

et al. 2020

WJGS

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BACKGROUND Palliative therapy has been associated with improved overall survival (OS) in several tumor types. Not all patients with metastatic esophageal cancer receive palliative chemotherapy, and the roles of other palliative therapies in these patients are limited. AIM To investigate the impact of other palliative therapies in patients with metastatic esophageal cancer not receiving chemotherapy. METHODS The National Cancer Database was used to identify patients between 2004-2015. Patients with M1 disease who declined chemotherapy and had known palliative therapy status [palliative therapies were defined as surgery, radiotherapy (RT), pain management, or any combination thereof] were included. Cases with unknown chemotherapy, RT, or nonprimary surgery status were excluded. Kaplan-Meier estimates of OS were calculated. Cox proportional hazards regression models were employed to examine factors influencing survival. RESULTS Among 140234 esophageal cancer cases, we identified 1493 patients who did not receive chemotherapy and had complete data. Median age was 70 years, most (66.3%) had a Charlson Comorbidity Index (CCI) of 0, and 37.1% were treated at an academic center. The majority (72.7%) did not receive other palliative therapies. On both univariate and multivariable analyses, there was no difference in OS between those receiving other palliative therapy (median 2.83 mo, 95%CI: 2.53-3.12) vs no palliative therapy (2.37 no, 95%CI: 2.2-2.56; multivariable P = 0.290). On univariate, but not multivariable analysis, treatment at an academic center was predictive of improved OS [Hazard ratio (HR) 0.90, 95%CI: 0.80-1.00; P = 0.047]. On multivariable analysis, female sex (HR 0.81, 95%CI: 0.71-0.92) and non-black, other race compared to white race (HR 0.72, 95%CI: 0.56-0.93) were associated with reduced mortality, while South geographic region relative to West region (HR 1.23, 95%CI: 1.04-1.46) and CCI of 1 relative to CCI of 0 (HR 1.17, 95%CI: 1.03-1.32) were associated with increased mortality. Higher histologic grade and T-stage were also associated with worse OS ( P < 0.05). CONCLUSION Palliative therapies other than chemotherapy conferred a numerically higher, but not statistically significant difference in OS among patients with metastatic esophageal cancer not receiving chemotherapy. Quality of life metrics, inpatient status, and subgroup analyses are important for examining the role of palliative therapies other than chemotherapy in metastatic esophageal cancer and future studies are warranted.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of palliative therapies in metastatic esophageal cancer patients not receiving chemotherapy

Kim¹,

DiPeri²,

Guan³

et al. 2020

WJGS

View full text Add to dashboard Cite

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“…Since the quality of life of patients and their families benefit from this care increases, it will be easier for them to manage disturbing clinical complications during the delivery of life-sustaining treatments (Bridge, 2008;Munoz-Mendoza, 2015;Evans, Mackinnon, Pereira, Earle, Gagnon, Arthurs, Gradin, … & Wright, 2019). Perrar et al (2015), stated that palliative care should improve the quality of life of patients and their families with a life-threatening or limiting disease by addressing their physical, psychosocial, and spiritual needs, while Lee et al (2019), emphasized the importance of this care being complementary to oncological interventions. While applying palliative care, the importance of family-centered care was emphasized, and it was emphasized that autonomy, access to information, and intellectual, emotional, and spiritual needs should be met (Perrar, Schmidt, Eisenmann, Cremer & Voltz, 2015;Lee, Khulusi & Watson, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Perrar et al (2015), stated that palliative care should improve the quality of life of patients and their families with a life-threatening or limiting disease by addressing their physical, psychosocial, and spiritual needs, while Lee et al (2019), emphasized the importance of this care being complementary to oncological interventions. While applying palliative care, the importance of family-centered care was emphasized, and it was emphasized that autonomy, access to information, and intellectual, emotional, and spiritual needs should be met (Perrar, Schmidt, Eisenmann, Cremer & Voltz, 2015;Lee, Khulusi & Watson, 2019). Palliative care is a very useful care approach for the patient and his family, as well as for the delivery of health services or the outcomes to be obtained after.…”

Section: Introductionmentioning

confidence: 99%

Palyatif Bakımda Yaşlı Hasta ve Ailesine Verilen Psikososyal Desteğin Etkisi

Sarman

KÖSE

Sarman³

2022

Yaşlı Sorunları Araştırma Dergisi

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Diseases that are life-threatening and require long-term treatment affect the patient and his family in many ways. Interdisciplinary care is applied to people who are being treated for these diseases. Through this care, aims to prevent and alleviate the pain that occurs with proper planning, which improves the quality of life, prevents physical, psychosocial and mental problems such as pain. This understanding of care, which provides for a multi-dimensional assessment process, focuses on maintaining the patient's routine in the normal course of life and considers death as part of the normal process, is called palliative care. This article aims to provide information about psychosocial supportive nursing interventions in palliative care, their components, and the effects of these interventions. The care that patients and their families want to receive in the conditions to which they are accustomed in the last period of their lives, who have to fight a deadly disease and the negative processes that it brings, can help them calmly go through this period, protect a person from dangers for the physical and psychological health, improve quality of life, improve the healing process. It has been found to help prevent negative emotions such as post-traumatic stress disorder and post-traumatic stress disorder. It is believed that increasing the number of research in this area will improve the quality of care and improve patient satisfaction.

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Gastroesophageal cancer patients need earlier palliative intervention - Using data to inform appropriate care

Cited by 2 publications

References 32 publications

Impact of palliative therapies in metastatic esophageal cancer patients not receiving chemotherapy

Impact of palliative therapies in metastatic esophageal cancer patients not receiving chemotherapy

Palyatif Bakımda Yaşlı Hasta ve Ailesine Verilen Psikososyal Desteğin Etkisi

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