ArticleJournal of pain and symptom management2018
Chemotherapy Use, End-of-Life Care, and Costs of Care Among Patients Diagnosed With Stage IV Pancreatic Cancer.
Article in Journal of pain and symptom management, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses 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
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Describing financial toxicity among cancer patients in different income countries: a systematic review and meta-analysis.Frontiers in public health · 2023Pooled it
- The Out-of-Pocket Cost Burden of Cancer Care-A Systematic Literature Review.Current oncology (Toronto, Ont.) · 2021Pooled it
- Integrated Palliative care in Metastatic gastrointestinal Cancer: A Retrospective Experience from a Lead Cancer Centre in Pakistan.Journal of cancer & allied specialties · 2026Article
- Financial Toxicity Profiles and Associated Factors in Patients with Advanced Cancer Receiving Daytime Chemotherapy: A Latent Profile Analysis.Cancer management and research · 2026Article
- Cancer care at the end of life: system-wide expenditure in a national health service.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Novel Systemic Anticancer Treatments and Health Services Use at the End of Life Among Adults With Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- 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
- Trajectory of quality of life among patients with cancer at the end of life: a longitudinal survey study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- NELBI score: a new clinical calculator of thirty-day mortality following systemic anticancer therapy in breast cancer patients near the end of life.Breast cancer (Tokyo, Japan) · 2025Article
- Development and Validation of a Survival Prediction Model for Patients With Pancreatic Cancer.Clinical and translational gastroenterology · 2025Article
- Economic evaluation of NALIRIFOX vs. nab-paclitaxel and gemcitabine regimens for first-line treatment of metastatic pancreatic ductal adenocarcinoma from U.S. perspective.Cost effectiveness and resource allocation : C/E · 2024Article
- Systemic Anticancer Therapy and Overall Survival in Patients With Very Advanced Solid Tumors.JAMA oncology · 2024Article
- Systemic Anticancer Treatment Near the End of Life: a Narrative Literature Review.Current treatment options in oncology · 2023Review
- Initial treatment is associated with improved survival and end-of-life outcomes for patients with pancreatic cancer: a cohort study.BMC cancer · 2022Article
- Integration of Specialized Palliative Care with Oncological Treatment in Patients with Advanced Pancreatic Cancer.Journal of pancreatic cancer · 2022Article
- Out-of-pocket costs associated with head and neck cancer treatment.Cancer reports (Hoboken, N.J.) · 2022Article
- 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
- Chemotherapy during the last 30 days of life and the role of palliative care referral, a single center experience.BMC palliative care · 2022Article
- The impact of spleen volume on the survival of metastatic pancreatic adenocarcinoma patients receiving nanoliposomal irinotecan.American journal of cancer research · 2022Article
- Factors associated with the initiation of chemotherapy within 90 days of death in metastatic colorectal cancer patients: a population-based study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
contextFor patients with metastatic cancer and limited life expectancy, potential benefits of chemotherapy must be balanced against harms to quality of life near death and increased out-of-pocket costs of care.
objectivesTo evaluate the association between chemotherapy use by patients with Stage IV pancreatic cancer and health care use and Medicare and out-of-pocket costs in the last 30 days of life.
methodsWe conducted a retrospective cohort study of 3825 patients aged 66 years or older when diagnosed with Stage IV pancreatic cancer in 2006-2011, using the linked Surveillance, Epidemiology, and End Results-Medicare data. Using a propensity score matched sample, we examined associations between initiation of chemotherapy shortly after the metastatic diagnosis (and secondarily, continued chemotherapy use in the last 30 days of life) and health care use and costs (both Medicare payment and patient out-of-pocket costs) in the last 30 days of life.
resultsChemotherapy use was associated with increased rates of hospital admissions (45.0% vs. 29.2%, P < 0.001), emergency department visits (41.3% vs. 27.2%, P < 0.001), and death in a hospital (14.2% vs. 9.1%, P < 0.001); fewer days in hospice care (11.5 days vs. 15.7 days, P < 0.001); and more than 50% increase in patient out-of-pocket costs for care ($1311.5 vs. $841.0, P < 0.001) in the last 30 days of life. Among patients who initiated chemotherapy, more stark differences in these outcomes were found by whether patients received chemotherapy in the last 30 days of life.
conclusionChemotherapy use among older patients diagnosed with metastatic pancreatic cancer was associated with substantially increased use of health care and higher patient out-of-pocket costs near death.
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