Palliative care consultations helped patients with esophageal cancer at end-of-life experience better quality of life and less financial strain by reducing the need for intensive interventions, according to a poster presented at the 2025 ASCO Gastrointestinal Cancers Symposium.
The mean length of hospital stay was 7.5 days (plus or minus 11.3 days) for patients who received palliative care and 8.9 days (plus or minus 14.9) for those who didn’t; and total charges were $97,879 (plus or minus $195,868) and $146,128 (plus or minus $321,830), respectively. Patients who received palliative care consultation had a Charlson Comorbidity Index of 9.4 (plus or minus 3.3) versus 9.1 (plus or minus 3.5) for patients who did not.
Of patients to receive and not to receive a palliative care consultation, 0.9% and 1.6%, respectively, underwent chemotherapy; 12.3% and 18% underwent blood transfusion; and 28.5% and 41.0% underwent mechanical ventilation.
“Some patients continue to receive burdensome interventions which significantly deteriorate quality of life,” Dr. Suriya Baskar, a second-year resident in the Internal Medicine Department at the Brooklyn Hospital Center, and lead investigator of the study, wrote in the presentation. “These findings highlight the importance of early integration of palliative care in [patients with esophageal cancer] with advanced disease.”
Glossary:
Palliative care: care given to help reduce pain and improve quality of life in patients with diseases like cancer. The goal of this care is to prevent or treat the symptoms of the disease and its side effects as early as possible.
Charlson Comorbidity Index: a tool used to predict the risk for death in a patient based on the presence of other health conditions. For example, a score of 9 indicates a high burden of comorbidity and is linked with a significantly increased risk for mortality.
Vasopressor: a medication that causes blood vessels to narrow as a treatment for low blood pressure.
In this study, a total of 17,745 patients were included; 10,370 of whom received palliative care consultation and 7,375 of whom did not. Patient data was gathered to identify all esophageal cancer hospitalizations between 2016 and 2020.
Of the patients indexed, 20% and 19.6% in the palliative consultation and no palliative consultation groups, respectively, were female. The median age was 67.58 (plus or minus 10.9) in both groups.
A non-significant difference was found in the use of vasopressor between those who received a palliative care consultation and those who did not, 8.1% versus 8%, respectively. There was, however, a significant difference in the rates of do-not-resuscitate orders between patients who did and did not receive palliative care consultations, 78.1% versus 43.2%, respectively.
“Esophageal cancer is an aggressive malignancy with a high global prevalence,” Baskar said. “Hospitalizations of [patients with esophageal cancer] at [end of life] with palliative care consultations received less aggressive interventions considerably improving [quality of life] while simultaneously reducing financial burden.”
The investigators also highlighted barriers to palliative care consultations, the impact of the timing of palliative care consultations on outcomes and the number of patients with esophageal cancer that are admitted to hospice at end of life as potential future avenues of research.
Reference:
Impact of inpatient palliative care consultation on end-of-life care among patients with esophageal cancer. Dr. Suriya Baskar, et al. J Clin Oncol.
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