Login to Access Video or Poster Abstract: MP69-12
Sources of Funding: none

Introduction

Comprehensive cancer care aims to reduce disease mortality while simultaneously maximizing patient quality of life. Palliative care addresses the morbidity of cancer and cancer treatments and should be offered in conjunction with traditional therapy. Recent randomized trials demonstrate that early referral to palliative care for advanced malignancy is associated with not only improved quality of life, but survival as well. Despite these findings, their services may remain underutilized. The aim of this study was to assess patterns of care in the use of palliative care services for advanced genitourinary malignancies.

Methods

Data from the National Cancer Database was queried for Stage III and IV genitourinary malignancies (prostate, renal, bladder, penile, and testicular). Patient and facility characteristics were compared in those who received palliative care treatments versus those who did not. Comorbidities were stratified by Charlson-Deyo score. Logistic regression models were used to identify factors associated with palliative care.

Results

We identified 377,248 patients with advanced GU malignancies between 2004-2014. Only 24,224 (6%) were referred to palliative care and 12,284 (15%) died within 1 year of diagnosis. Multivariable analysis revealed that advanced disease and death within one year of diagnosis were most strongly associated with palliative care. Additionally, older age, more co-morbidities, uninsured, female gender, lower income and decreased education and treatment at low volume and academic centers were associated with utilization of palliative care, p<0.05, respectively (Table). Over the study period there was a significant, although, modest increase in the utilization of palliative services (5.5% in 2004 to 7.7% in 2014, p<.001).

Conclusions

Relatively few patients with advanced GU malignancies receive palliative care. While referrals increased in recent years, palliative care remains under-utilized and remains an opportunity for educational engagement with patients and physicians alike.

Funding

none