ArticleJournal of pain and symptom management2016
Chemotherapy Use in the Months Before Death and Estimated Costs of Care in the Last Week of Life.
Article in Journal of pain and symptom management, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Associations Among End-of-Life Discussions, Health-Care Utilization, and Costs in Persons With Advanced Cancer: A Systematic Review.The American journal of hospice & palliative care · 2019Pooled it
- Toward a National Health Digital and Data Architecture: Laying the Foundation for Digital Transformation: Commission on Investment Imperatives for a Healthy Nation.NAM perspectives · 2026Review
- Evaluation of end-of-Life chemotherapy: a medical and economic challenge revealed by a retrospective observational study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Observational
- Surgical Treatment Intensity at the End of Life in Patients With Cancer: A Systematic Review.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Review
- Differences in Health Care Expenditures by Cancer Patients During Their Last Year of Life: A Registry-Based Study.Current oncology (Toronto, Ont.) · 2024Article
- Aggressiveness of Cancer Care at End of Life in Patients with Metastatic Breast Cancer in Jordan.Journal of multidisciplinary healthcare · 2023Article
- Polypharmacy, chemotherapy receipt, and medication-related out-of-pocket costs at end of life among commercially insured adults with advanced cancer.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2022Article
- Do-Not-Resuscitate Orders and Outcomes for Patients with Pancreatic Cancer.Journal of pancreatic cancer · 2022Article
- Observational
- PD-1/PD-L1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort.Journal of translational medicine · 2021Article
- Racial Disparities in End-of-Life Care Between Black and White Adults With Metastatic Cancer.Journal of pain and symptom management · 2021Article
- How aging of the global population is changing oncology.Ecancermedicalscience · 2021Article
- Assessing the Impact of a Novel Integrated Palliative Care and Medical Oncology Inpatient Service on Health Care Utilization before Hospice Enrollment.Journal of palliative medicine · 2019Article
- Medical care costs of cancer in the last year of life using national health insurance data in Korea.PloS one · 2018Article
- Feasibility and Safety of Pressurized Intraperitoneal Aerosol Chemotherapy for Peritoneal Carcinomatosis: A Retrospective Cohort Study.Gastroenterology research and practice · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
contextConsiderable attention has been paid to the disproportionately high costs of care for patients nearing death, yet little is known about the costs associated with chemotherapy use among end-stage cancer patients.
objectivesTo compare costs of care other than chemotherapy in the last week of life based on whether cancer patients were using chemotherapy in the months just before death.
methodsA total of 311 patients with advanced cancer who died between 2002 and 2008 were studied. Data included medical records, patient baseline surveys (median four months before death), and postmortem interviews of caregivers and clinicians. Costs of care were estimated based on reports of death site and services other than chemotherapy received in the week before death (e.g., resuscitation). We tested whether end-of-life (EOL) care preferences, do-not-resuscitate order completion, or EOL discussions accounted for relationships between chemotherapy use and estimated care costs.
resultsHalf (50.5%) of patients were receiving chemotherapy at baseline. Estimated EOL care costs for patients with baseline chemotherapy use (median = $2681) were significantly higher than for patients without baseline chemotherapy use (median = $1092) (P = 0.003). This relationship persisted after adjusting for sociodemographic and clinical characteristics in a generalized linear model (mean incremental cost = $2681, 95% confidence interval $611-$4751, P = 0.01). None of the psychosocial variables accounted for the relationship between chemotherapy use and estimated care costs.
conclusionChemotherapy for end-stage cancer patients is associated with higher estimated EOL care costs. Given evidence of limited benefit and potential harm of chemotherapy for end-stage cancer patients, the cost-effectiveness of such care is questioned and further study warranted.
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