Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 30;9(4):299-309.
doi: 10.1093/nop/npac026. eCollection 2022 Aug.

Trends and outcomes of early and late palliative care consultation for adult patients with glioblastoma: A SEER-Medicare retrospective study

Adela Wu  1 , Beatrice Ugiliweneza  2 , Dengzhi Wang  2 , Gary Hsin  3 , Maxwell Boakye  2 , Stephen Skirboll  1
Affiliations

Trends and outcomes of early and late palliative care consultation for adult patients with glioblastoma: A SEER-Medicare retrospective study

Adela Wu et al. Neurooncol Pract. .

Abstract

Background: Glioblastoma (GBM) carries a poor prognosis despite standard of care. Early palliative care (PC) has been shown to enhance survival and quality of life while reducing healthcare costs for other cancers. This study investigates differences in PC timing on outcomes for patients with GBM.

Methods: This study used Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 1997 to 2016. Based on ICD codes, three groups were defined: (1) early PC within 10 weeks of diagnosis, (2) late PC, and (3) no PC. Outcomes were compared between the three groups.

Results: Out of 10 812 patients with GBM, 1648 (15.24%) patients had PC consultation with an overall positive trend over time. There were no significant differences in patient characteristics. The late PC group had significantly higher number of hospice claims (1.06 ± 0.69) compared to those without PC, in the last month of life. There were significant differences in survival among the three groups (P < .0001), with late PC patients with the longest mean time to death from diagnosis (11.72 ± 13.20 months).

Conclusion: We present the first investigation of PC consultation prevalence and outcomes, stratified by early versus late timing, for adult GBM patients. Despite an overall increase in PC consultations, only a minority of GBM patients receive PC. Patients with late PC had the longest survival times and had greater hospice use in the last month of life compared to other subgroups. Prospective studies can provide additional valuable information about this unique population of patients with GBM.

Keywords: glioblastoma; healthcare costs; hospice; palliative care; resource utilization.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow chart of glioblastoma (GBM) decedents included for analysis, derived from SEER-Medicare database of 1997–2016.
Fig. 2
Fig. 2
Kaplan-Meier survival curve depicting survival probability over time for glioblastoma (GBM) patients who had no palliative care (PC) referral versus early PC referral versus late PC referral. Statistical significance among all three curves was depicted by P value < .0001.
Fig. 3
Fig. 3
Trends in palliative care referral over time for glioblastoma (GBM) patients.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Stupp R, Taillibert S, Kanner AA, et al. . Maintenance therapy with tumor-treating fields plus temozolomide vs temozolomide alone for glioblastoma: a randomized clinical trial. JAMA. 2015;314(23):2535–2543. - PubMed
    1. Nabors LB, Portnow J, Ahluwalia M, et al. . Central nervous system cancers, version 3.2020. JNCCN J Natl Compr Cancer Netw. 2020;18(11):1537–1570. - PubMed
    1. Palliative Care. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/palliative-care. Accessed April 5, 2022.
    1. Mor V, Wagner TH, Levy C, et al. . Association of expanded VA hospice care with aggressive care and cost for veterans with advanced lung cancer. JAMA Oncol. 2019;5:810–816. - PMC - PubMed
    1. Holmenlund K, Sjogren P, Nordly M. Specialized palliative care in advanced cancer: What is the efficacy? A systematic review. Palliat Support Care. 2017;15(6):724–740. - PubMed