Observational studyBMC palliative care2019
Timing of palliative care referral and aggressive cancer care toward the end-of-life in pancreatic cancer: a retrospective, single-center observational study.
Observational study in BMC palliative care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 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
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- How views of oncologists and haematologists impacts palliative care referral: a systematic review.BMC palliative care · 2020Pooled it
- Early Incorporation to Palliative Care (EPC) in Patients With Advanced Non-Small Cell Lung Cancer: The PACO Randomized Clinical Trial.The oncologist · 2024Trial
- The impact of early palliative care on the quality of life of patients with advanced pancreatic cancer: The IMPERATIVE case-crossover study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Trial
- Improving Palliative Care and Quality of Life in Pancreatic Cancer Patients.Journal of palliative medicine · 2022Trial
- The Impact of Early Palliative Care Decisions on Hospital Service Utilization and End-of-Life Care in Patients with Pancreatic Cancer-A Retrospective Study.Journal of palliative care · 2026Article
- Trends and outcomes of inpatient palliative care use among older Thai patients with pancreatic cancer: a nationwide analysis, 2017-2024.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Palliative care in pancreatic cancer: effects on symptom burden, survival, and place of death.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Review
- Associations Between Symptom Complexity and Acute Care Utilization Among Adult Advanced Cancer Patients Followed by a Palliative Care Service.Current oncology (Toronto, Ont.) · 2025Observational
- Palliative Care Referral Patterns and Outcomes for Patients with End-Stage Liver Disease at an Academic Liver Transplant Center.Journal of palliative medicine · 2025Article
- Navigating pain and appetite challenges in palliative care for pancreatic cancer: insights from a national, longitudinal consecutive cohort study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Prevalence of aggressive care among patients with cancer near the end of life: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Palliative radiotherapy and the introduction of a Rapid Access Palliative Clinic in a national radiation oncology network.Irish journal of medical science · 2024Review
- Leveraging real-world data to predict cancer cachexia stage, quality of life, and survival in a racially and ethnically diverse multi-institutional cohort of treatment-naïve patients with pancreatic ductal adenocarcinoma.Frontiers in oncology · 2024Article
- Impact of early vs late palliative care referrals on healthcare utilization in patients with pancreatic cancer.Journal of cancer research and clinical oncology · 2023Article
- Shared decision making with Oncologists and Palliative care specialists (SOP) model help advanced pancreatic cancer patients reaching goal concordant care: A prospective cohort study.Cancer medicine · 2023Article
- Characteristics of patients diagnosed with pancreatic cancer who access palliative care: An observational study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023Observational
- Association of rurality with utilization of palliative care and hospice among Medicare beneficiaries who died from pancreatic cancer: A cohort study.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2023Article
- Review
- Impact of the COVID-19 Pandemic on the Management and End-of-life Care of Unresectable Pancreatic Cancer.Internal medicine (Tokyo, Japan) · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPancreatic cancer is noted for its late presentation at diagnosis, limited prognosis and physical and psychosocial symptom burden. This study examined associations between timing of palliative care referral (PCR) and aggressive cancer care received by pancreatic cancer patients in the last 30 days of life through a single health service.
methodA retrospective cohort analysis of end-of-life (EOL) care outcomes of patients with pancreatic cancer who died between 2012 and 2016. Key indicators of aggressive cancer care in the last 30 days of life used were: ≥1 emergency department (ED) presentations, acute inpatient/intensive care unit (ICU) admission, and chemotherapy use. We examined time from PCR to death and place of death. Early and late PCR were defined as > 90 and ≤ 90 days before death respectively.
resultsOut of the 278 eligible deaths, 187 (67.3%) were categorized as receiving a late PCR and 91 (32.7%) an early PCR. The median time between referral and death was 48 days. Compared to those receiving early PCR, those with late PCR had: 18.1% (95% CI 6.8-29.4%) more ED presentations; 12.5% (95% CI 1.7-24.8%) more acute hospital admissions; with no differences in ICU admissions. Pain and complications of cancer accounted for the majority of overall ED presentations. Of the 166 patients who received chemotherapy within 30 days of death, 23 (24.5%) had a late PCR and 12 (16.7%) an early PCR, with no association of PCR status either unadjusted or adjusted for age or gender. The majority of patients (55.8%) died at the inpatient palliative care unit.
conclusionOur findings reaffirm the benefits of early PCR for pancreatic cancer patients to avoid inappropriate care toward the EOL. We suggest that in modern cancer care, there can sometimes be a need to reconsider the use of the term 'aggressive cancer care' at the EOL when the care is appropriately based on an individual patient's presenting physical and psychosocial needs. Pancreatic cancer patients warrant early PCR but the debate must thus continue as to how we best achieve and benchmark outcomes that are compatible with patient and family needs and healthcare priorities.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.