Palliative Care Utilization Trends in Advanced Renal Cell Carcinoma
Posted: Tuesday, January 12, 2021
According to Hiren V. Patel, MD, PhD, of Rutgers Cancer Institute of New Jersey, and colleagues, palliative care is often misunderstood. Based on their recent study, they found that “early, more equitable, and systematic use of palliative care among patients with advanced renal cell carcinoma is necessary.” In addition, they noted at the 2020 Annual Meeting of the International Kidney Cancer Symposium (IKCS; Abstract NAS115), reducing barriers to the use of this supportive care may increase its use in this patient population.
It is well known that end-of-life comfort and quality of life are improved by palliative care; this includes decreased pain, anxiety, and depression, all while decreasing overall cost and utilization of intensive care. Due to these circumstances, several guidelines have adopted an early administration of palliative therapy into oncologic care regimens. The data from 62,136 patients from the National Cancer Database were obtained for this study. Individuals who had unknown or missing palliative care status or non–renal cell carcinoma histology were excluded from the analysis. Patients were categorized according to the stage of disease and the use of palliative care.
A total of 20,122 participants had stage III renal cell carcinoma, and 42,014 had stage IV disease. Palliative care was utilized in 13.8% of the cohort, with 236 and 7,912 having stage III and IV renal cell carcinoma, respectively. In the mid-2000s, the use of palliative care in patients with stage IV renal cell carcinoma increased, whereas the rate among patients with stage III disease remained the same.
Patients with sarcomatoid histology, higher education levels, government-sponsored or no health insurance, or who received systemic therapy with or without surgery seemed to be more likely to receive palliative care. Unfortunately, patients who had higher incomes, underwent surgery, or were Black were less likely to receive palliative care, according to the reported findings.
Disclosure: The study authors reported no conflicts of interest.