WCLC 2025 - Posters & ePosters-EP.15.11 Patterns of Care and Outcomes in Patients With Advanced Lung Cancer in a Hospital Palliative Care Unit: A Single-Center Retrospective Study

EP.15.11 Patterns of Care and Outcomes in Patients With Advanced Lung Cancer in a Hospital Palliative Care Unit: A Single-Center Retrospective Study

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This single-center retrospective study analyzed patterns of care and outcomes in 144 patients with advanced lung cancer (ALC) admitted to a hospital-based Palliative Care Unit (PCU) at Modena University Hospital from January 2022 to September 2024. The median patient age was 75 years, with 11.8% lacking a histological diagnosis due to clinical decline and ineligibility for active treatments. At admission, 36% had received systemic therapy in the prior 30 days, including chemotherapy (44%), immunotherapy (27%), chemo-immunotherapy (15%), and targeted therapy (12%). The median interval from diagnosis to PCU admission was 4.8 months.<br /><br />Most patients (77.8%) were transferred from other hospital wards, and notably, 73% were not receiving active home-based palliative care at admission. Symptom burden was substantial: the mean Edmonton Symptom Assessment System (ESAS) score was 27 (IQR 20–42), 55.6% had severe target symptoms (PERSONS score), and main issues included dyspnea, pain, neurological symptoms, and clinical deterioration. Palliative sedation was used in 25.7%, primarily for refractory dyspnea and agitation.<br /><br />Median overall survival (OS) after PCU admission was short, at 13 days. However, 30% were discharged home or to other facilities, with a significantly longer median OS of 46 days versus 8 days for those who died within the unit. The study highlights challenges in managing ALC patients with rapid clinical decline and high symptom burden.<br /><br />Key conclusions emphasize the importance of hospital-based PCUs in providing effective symptom control, end-of-life care, and continuity between oncology and palliative teams. The notable proportion of patients receiving systemic therapy shortly before PCU admission raises concerns about the timing and appropriateness of late-line treatments, underscoring the value of earlier palliative care integration to improve quality of life—even for patients without confirmed histological diagnoses.

Asset Subtitle

Rita Leporati

Meta Tag

Speaker Rita Leporati

Topic Multidisciplinary Care: Nursing, Allied Health and Palliative Care

Keywords

advanced lung cancer

palliative care unit

symptom burden

systemic therapy

hospital-based palliative care

end-of-life care

overall survival

palliative sedation

clinical decline

early palliative care integration