A retrospective cohort study of onco-hematologic inpatients with SACT at the end of life in a single cancer institution: Differences between solid tumors and hematological neoplasms

Abstract

Background: This study compares mortality indicators in patients with solid tumors (ST) and hematological neoplasms (HN) who died in the hospital during systemic anticancer therapy (SACT) in the last 30 days of life. We used indicators described by Earle: SACT<30d, SACT<14d, therapeutic regimen changes, and palliative care referrals. We also analyzed the impact of palliative care availability on patient survival.

Methods: Between 2017 and 2022, we identified, validated, and registered 2285 cases through our institution's Mortality Subcommittee (MS) that met the inclusion criteria for this cohort.

Results: We observed differences in indicators between ST and HN consistent with published literature. These differences occurred both in therapeutic intensity (higher in HN) and in palliative care referrals (higher percentage for ST). When analyzing survival from advanced disease definition to death, no statistically significant differences emerged between patients with HN versus ST, or between those with and without palliative care.

Conclusions: The published differences between subgroups (ST vs HN) persist even in our hospital death cohort, confirming the need for pathology-specific standards.

Keywords: Agentes antineoplásicos; Anticancer agents; Chemotherapy; Cuidados paliativos; End of life; Final de la vida; Hematological neoplasms; Intensive treatment; Neoplasias hematológicas; Palliative care; Quimioterapia; SACT; Solid tumors; Supervivencia; Survival; Tratamiento intensivo; Tumores sólidos.