An examination of patients with newly diagnosed non-small cell lung cancer receiving only the best supportive care
Nahoko Sato Yuichiro Takeda Haruna Masaki Yuki Katsuya Haruka Chino Satoru Ishii Go Naka Motoyasu Iikura Masaaki Hojo Haruhito Sugiyama
Department of Respiratory Medicine, National Center for Global Health and Medicine
Purpose: Examine the clinical features of patients with newly diagnosed non-small cell lung cancer (NSCLC) receiving only the best supportive care (BSC) available as a result of patient decision or high risk. Identify the factors related to transfer to a palliative care unit (transfer to hospice). Methods: Seventy-five patients were in our department from November 2004 to December 2012 with newly diagnosed NSCLC receiving only BSC for their remaining lives. We retrospectively examined their characteristics and prognoses. Results: The initial discharge outcomes were as follows: general hospital ward 32%, transfer to hospice 20%, and home medical care 48%. The median overall survival period (mOS) was 24 days for general hospital wards, 67 days for transfer to hospice, and 218 days for home care. Multivariate logistic regression of factors related to survival of more than the mOS for transfer to hospice (67 days), adjusted by stage and ECOG performance status, showed that high albumin levels [Alb, odds ratio (OR) =4.12] and high hemoglobin levels (Hb, OR=1.46) were associated with survival of longer than 67 days. Conclusion: Low Alb and Hb were associated with survival periods shorter than the mOS for transfer to hospice. It appears that when patients receiving only BSC had low Alb and Hb, transferring them to hospices was difficult.
Non-small cell lung cancer Transfer to hospices Best supportive care End-of-life care
Received 28 Apr 2014 / Accepted 16 Sep 2014
AJRS, 4(1): 59-65, 2015