Palliative care and end-of-life care in metastatic pancreatic cancer.

Abstract

544 Background: Patients with metastatic pancreatic cancer (mPC) have a 5-year survival of 2.7%. Studies have shown that patients with mPC receive aggressive end of life (EOL) care which has been associated with worse quality of life for patients and high use of resources when they are least likely to benefit patients. Methods: A retrospective database of patients with mPC treated at Fox Chase Cancer Center between 2010 and 2019 was analyzed for utilization of palliative care and EOL care. Statistical analysis was performed using one-sample Z tests calculated in Excel. Results: We identified 610 patients with mPC, of whom 39% received palliative care, 56% were referred to hospice, and 91.8% are deceased. The average time from mPC diagnosis to palliative care consult was 232 days, the average time from palliative care consult to death was 121 days. Patients who received palliative care were less likely to receive chemotherapy within 14 days of death (7.7% vs 13.3%, p =0.05), more likely to have a DNR code status (83.3% vs 44.5%, p < 0.0001), and more likely to be referred to hospice (83.9% vs 35.9%, p < 0.0001). The average length of time on hospice was 24 days with no difference between those who received palliative care and those who did not. Patients who were referred to hospice were also less likely to receive chemotherapy within 14 days of death (6.7% vs 19.8%, p < 0.0001). Conclusions: Patients with mPC who had a palliative care team involved in their care were significantly less likely to receive aggressive EOL care.