Health

Palliative Care: A Game-Changer for Esophageal Cancer Patients' Quality of Life and Cost Efficiency

2025-01-27

Author: Sarah

Introduction

A groundbreaking study presented at the 2025 ASCO Gastrointestinal Cancer Symposium has unveiled that esophageal cancer patients who engaged in palliative care consultations experienced a remarkable enhancement in their quality of life (QOL) while also alleviating financial burdens during their final days.

Study Findings

The data showed that the average hospital stay for those receiving palliative care was 7.5 days (±11.3 days), compared to 8.9 days (±14.9) for those who did not receive such care (P < 0.001). In terms of total hospital costs, patients benefiting from palliative care incurred expenses averaging $97,879 (±$195,868), markedly less than the $146,128 (±$321,830) for patients without palliative care (P < 0.001). Moreover, the Charlson Comorbidity Index—a measure of patient comorbidities—was slightly higher for those receiving palliative care (9.4 ± 3.3) compared to their counterparts (9.1 ± 3.5) (P < 0.001).

Trends in Treatment

The study noted distinct trends in the use of aggressive treatments: only 0.9% of patients receiving palliative care underwent chemotherapy versus 1.6% who did not (P < 0.001); blood transfusions were given to 12.3% of the former group and 18.0% of the latter (P < 0.001); and the rates of mechanical ventilation were 28.5% and 41.0%, respectively (P < 0.001).

Expert Insights

Dr. Suriya Baskar, a second-year resident in internal medicine at the Brooklyn Hospital Center and lead investigator, emphasized, "Some patients continue to receive burdensome interventions that significantly deteriorate their quality of life. These findings highlight the importance of early integration of palliative care for patients with advanced esophageal cancer."

Research Scope

This retrospective analysis encompassed 17,745 patients, of which 10,370 received palliative care consultations while 7,375 did not. Researchers utilized data from the National Inpatient Sample (NIS) to identify esophageal cancer hospitalizations from 2016 to 2020, using the 10th edition of the International Classification of Diseases (ICD-10) codes C15.x, which cover various esophageal cancer locations—ranging from the cervical to the abdominal parts.

Mortality and Treatment Preferences

A significant focus of the research was on in-hospital mortality and treatment preferences tied to palliative care. Among the patients analyzed, there was an almost equal gender distribution (20% of the palliative care group versus 19.6% of the non-palliative group were female, P = 0.56). However, racial demographics showed stark contrasts: 13.3% of those receiving palliative care were White compared to 71% in the other group, while 7.8% and 78.4% were Black, respectively (both P < 0.001). The median age was consistently around 67.58 (±10.9) across the board (P = 0.98).

Usage of Medical Interventions

Notably, there was no significant difference in vasopressor usage—8.1% versus 8.0% (P = 0.83) between the two groups. However, a significant disparity was observed regarding do-not-resuscitate (DNR) orders, with 78.1% of patients who received palliative care having such orders compared to just 43.2% of those who did not (P < 0.001).

Conclusions

Dr. Baskar remarked on the aggressive nature of esophageal cancer and its widespread impact, saying, "Esophageal cancer is an aggressive malignancy with a high global prevalence. Hospitalizations at the end of life for these patients, when coupled with palliative care consultations, lead to less aggressive interventions, vastly improving their quality of life while simultaneously slashing financial burdens."

Call for Further Research

The investigators also acknowledged existing barriers to accessing palliative care consultations and called for further research into timing, outcomes, and the statistics surrounding esophageal cancer patients transitioning to hospice care at life's end.

Shift in Care Paradigm

This narrative underscores a crucial shift towards focusing on quality of life and cost-effective care for patients facing terminal illnesses, and palliative care is proving to be a vital component in achieving those goals.