Abstract
Aim: Fundamentally, aggressive care is considered to be avoided for the patients at the end of life. However, this is not always adhered in real-world practice. We attempted to determine whether, and if so how, the aggressive care is made for patients with ovarian cancer during the last month prior death. Methods: Enrolled were a total of 104 patients with ovarian cancer (including fallopian tube or primary peritoneal cancer), who were treated in Kuopio University Hospital in Finland during 2009-2014. The aggressive care was defined according to the standards outlined by the National Quality Forum; shortly, chemotherapy, emergency-room/intensive-care visit/admission, hospital admission, and death in hospital. Results: Two thirds of patients (67%) had received at least one form of aggressive care during the last month of their lives. Especially, admission in hospital in the last 30 days of life was the most common form of aggressive cancer care. Younger patients ( = 0.004). Those women that underwent end-of-life discussions earlier than one month prior to death had significantly less aggressive care than those women that had discussions during the last month (48% vs. 90%, p = 0.001). Conclusions: Ovarian cancer patients received commonly at least one form of aggressive care at the end of their lives. More efforts should be taken to improve the quality of palliative and end-of-life care.
Highlights
Ovarian cancer accounts for 5% of cancer deaths among women, causing more deaths than any other gynecological cancer
Enrolled were a total of 104 patients with ovarian cancer, who were treated in Kuopio University Hospital in Finland during 2009-2014
The aggressive care was defined according to the standards outlined by the National Quality Forum; shortly, chemotherapy, emergency-room/intensive-care visit/admission, hospital admission, and death in hospital
Summary
Ovarian cancer accounts for 5% of cancer deaths among women, causing more deaths than any other gynecological cancer. The standard primary treatment for ovarian cancer is cytoreductive surgery and a platinum-based combination therapy, mostly with paclitaxel [2]. Despite responding to the initial treatment, ovarian cancer is known to relapse in most patients and eventually leads to death [3]. The patients are often treated with multiple lines of chemotherapy. Women may have had even up to ten different lines of chemotherapy before eventual death [4]
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