However, when the timing of palliative care implementation was taken into account, substantially increased mortality was observed in those patients who received palliative care between 0 and 30 days from diagnosis vs not receiving palliative care (aHR, 2.13; 95% CI, 1.97-2.30).

Conversely, when compared with those who did not receive palliative care, mortality was significantly lower for patients for whom palliative care was implemented between 31 and 365 days from diagnosis (aHR, 0.47; 95% CI, 0.45-0.49).

No survival difference was observed between those who did or did not receive palliative care when palliative care was administered more than 365 days following cancer diagnosis aHR, 1.00; 95% CI, 0.94-1.07).


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In offering an explanation for these results, the study authors opined that “patients who receive palliative care soon after diagnosis (ie, 0 to 30 days) are more likely to be seriously ill; most of the initial palliative care encounters in this study occurred in the inpatient setting, and this supportive approach was intended to ease the dying process rather than increase survival. Patients who were less seriously ill at diagnosis and who received early palliative care were more likely to benefit from its multidisciplinary patient-centered approach, which may have been associated with their increased survival.”

The study authors commented that the results of this study “suggest the importance of considering the complementary role of palliative care delivered concurrently with disease-modifying therapies as a key component of comprehensive cancer care.

References

1. Sullivan DR, Chan B, Lapidus JA, et al. Association of early palliative care use with survival and place of death among patients with advanced lung cancer receiving care in the Veterans Health Administration [published online September 19, 2019]. JAMA Oncol. doi: 10.1001/jamaoncol.2019.3105

2. Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non–small-cell lung cancer. N Engl J Med. 2010;363(8):733-742.

3. Kavalieratos DCorbelli JZhang D, et al. Association between palliative care and patient and caregiver outcomes: a systematic review and meta-analysis.JAMA. 2016;316(20):2104-2114.