Lung cancer: patients benefit from combined treatment and hospice care

  • JAMA Oncol

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Use of aggressive treatment and ICU admissions were significantly lower among patients with advanced NSCLC treated at centers with the highest hospice exposure, even though patients at those centers were twice as likely to receive concurrent cancer therapy.

Why this matters

Study design

  • 13,085 veterans diagnosed with stage IV NSCLC and treated at a Veterans Affairs Medical Center.
  • Funding: U.S. Department of Veterans Affairs.

Key results

  • 21.5% of patients were admitted to an ICU and 32% experienced aggressive care.
  • Aggressive treatment and ICU admissions were significantly higher at centers with the lowest vs highest hospice exposure quintile (HEQ; aOR, 0.66; 95% CI, 0.53-0.81 and aOR, 0.78; 95% CI, 0.62-0.99, respectively).
  • Concurrent care was more common in high vs low HEQ centers (aOR, 2.28; 95% CI, 1.67-3.11).
  • Hospital costs were about $266 lower for patients treated in the highest HEQ facilities between days 8 and 30 of diagnosis.

Limitations

  • Retrospective study with an all-veteran, mostly white, male cohort.

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