Early palliative supportive care within the lung cancer committee (LCC): Descriptive study of the patient's characteristics after one year experience in a tertiary hospital

ABSTRACT

Background: Many studies have shown benefits of early Palliative Care(PC)in advanced lung cancer patients. There's increasing evidence about better symptom control and survival. A PC physician joined the multidisciplinary LCC last year. Despite the SARS-CoV2 pandemic,472 cases were presented to the LCC in 2020. 470 cases were presented in 2018, so his activity remains stable. Aims: To describe clinical profile of the patients presented to the LCC and early referred to PC. To compare patient's survival when referred from ambulatory setting or when they are admitted in hospital. Methods: Descriptive study.DATAAge, Gender, Comorbilities, Cancer Histology Tobacco exposure, TNM, Oncology Therapy, Survival time, Barthel, Charlson, Time to first PC consultation. ANALYSIS:T test to compare means of continuous variables and Chi-squared to compare proportions of categorical variables. Kaplan-Meier curve for survival analysis. Results: 41patients of 472(9%) were referred to PC. Males(75%),Median Age 72,87 years old(DS 11,95) no age differences by gender. Current Smokers 25%,Former smokers 65%.Hypertension 70%,Diabetes 45%,Dyslipemia 60%,Heart Failure45%, Renal impairment 35%. Barthelmean 63,6(DS22,7) Charlsonmean 6,5(DS2,35) Cancer Histology Squamous55%, Adenocarcinome35%, Small Cell 7,5%,Other Neuroendocrine2,5%, Disease Stage StageIV 65%, StageIII 55%, Cancer therapy Chemotherapy 44%,Radiotherapy 56%, Immunotherapy 30%.PC exclusive follow-up24,4%, PC and shared follow-up75,6%. Setting: Refered to Ambulatory PC 44%, Refered to PC when admitted in an hospital ward 56%. Time from LCC to PC visit Ambulatory setting: mean 27,7 days, median 14. Admitted hospital ward mean 63,14 days(p=0,036), Survival Ambulatory mean 142,12 days (DS 90,9), Admitted Hospital ward 59,68 days (DS 59,1)p=0,002. Conclusion: Patients referred from LCC to Ambulatory PC showed an early intervention and better survival profile. Collaboration between LCC and the PC team can improve the early PC support.