Evidence map›Paper›PMID 40851410›Full record

Trial reportCancer2025

Patient-reported discordance between care goals and treatment intent in advanced cancer.

Manan P Shah, Neil S Wenger, John Glaspy, Ron D Hays, Rebecca L Sudore, Maryam Rahimi, Lisa Gibbs, Sidharth Anand, Chi-Hong Tseng, Anne M Walling

Abstract readMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Cancer statistics, 2026.CA: a cancer journal for clinicians
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Manan P ShahDivision of Hematology/Oncology, University of California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-9749-2456
Neil S WengerDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles, California, USA.
John GlaspyDivision of Hematology/Oncology, University of California, Los Angeles, California, USA.
Ron D HaysDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0001-6697-907X
Rebecca L SudoreDepartment of Medicine, University of California, San Francisco, California, USA.
Maryam RahimiDepartments of Medicine and Family Medicine, University of California, Irvine, California, USA.
Lisa GibbsDepartments of Medicine and Family Medicine, University of California, Irvine, California, USA.
Sidharth AnandDivision of Hematology/Oncology, University of California, Los Angeles, California, USA.
Chi-Hong TsengDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles, California, USA.
Anne M WallingDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles, California, USA.

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
Mentoring Researchers in Advance Care Planning for Underrepresented Older Adults at Risk for Alzheimer’s Disease and Related Dementias and Their CaregiversK24AG054415 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI REBECCA L SUDORE · 2017 to 2026
$1.7M
National Center for Advancing Translational Sciences (NCATS) Grant UL1TR001881NCATS NIH HHS UL1 TR001881NIA NIH HHS K24 AG054415Patient-Centered Outcomes Research Institute PLC-1609-36291
6 · The paper itself

Abstract

purposeGoal-concordant care is achieved when treatment is aligned with goals. This study describes patient-reported concordance between care goals and treatment intent in advanced cancer compared to other serious illnesses.

methodsA post hoc cross-sectional analysis of baseline survey responses was conducted in adult patients enrolled in a multisite trial of advance care planning. Patients reported whether they prefer and whether they are receiving treatment that prioritizes longevity (life-extending care) versus comfort (comfort-focused care). Concordance between care preferences and perceived treatment intent in patients with advanced cancer versus other advanced illnesses was compared. Mortality rates for patients with cancer stratified by perceived care concordance are reported.

resultsAmong 1099 patients, those with advanced cancer (n = 231) reported similar preference for comfort-focused care (49% vs 48%, p = .47) and had similar 24-month mortality (16% v 13%, p = .25) as patients with other serious illnesses (n = 868). Among patients preferring comfort-focused care, patients with cancer (n = 113) were more likely than patients with other illnesses (n = 413) to report receiving (discordant) life-extending care (37% vs. 19%, p < .001). Among patients with cancer preferring comfort-focused care, there was no statistically significant difference in 24-month mortality between those who reported receiving (discordant) life-extending versus (concordant) comfort-focused care (24% v 15%, p = .31).

conclusionCompared to patients with other serious illnesses, a relatively large portion of patients with advanced cancer reported that their treatment discordantly focused on longevity over comfort despite their goal to prioritize comfort over longevity.

Indexed as

Advance Care PlanningNeoplasmsPatient PreferenceAdultAgedAged, 80 and overCross-Sectional StudiesFemaleGoalsHumansMaleMiddle AgedPalliative CarePatient Reported Outcome Measuresadvance care planningadvanced cancercare concordancegoals of carepatient‐reported

Identifiers

PMID40851410
PMCPMC12581213

What OpenQuestion holds

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Registered trials

None linked

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.