Palliative care does not improve health-related quality of life (HRQOL) among patients undergoing curative-intent surgery for upper gastrointestinal cancer, according to research published in JAMA Network Open.
The study included 359 patients from 5 geographically diverse academic medical centers in the United States (ClinicalTrials.gov Identifier: NCT03611309).
Patients were undergoing curative-intent surgery for an upper gastrointestinal cancer and were randomly assigned to surgery plus palliative care (n=182) or surgery alone (n=177).
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Patients assigned to the palliative care arm met with the palliative care team either in person or via phone before surgery and after surgery at 1 week, 1 month, 2 months, and 3 months.
Of the 182 patients in the palliative care arm, 164 had at least 1 visit with the palliative care team. The mean number of visits in 3 months was 3.43, and the mean visit time was 30 minutes. There were no reports of harm related to palliative care.
Of the 177 patients in the control group, 20 met with the palliative care team in the 3 months after surgery. Nearly all of these palliative care visits (17/20) occurred at 1 study site.
When the researchers compared HRQOL outcomes at 3 months after surgery, there were no significant differences between the study arms.
The mean FACIT-Pal score was 138.54 in the control arm and 136.90 in the intervention arm (P =.62). The mean FACT-G score was 79.90 and 79.40, respectively (P =.80).
The mean PROMIS-29 physical health score was −0.43 in the control arm and −0.50 in the intervention arm (P =.56). The mean PROMIS-29 mental health score was −0.07 in both arms (P =.98), and the mean PROPr PROMIS score was 0.40 in both arms (P =.83).
There was no significant difference in mortality between the arms. There were 7 deaths in the intervention arm and 6 in the control arm (P >.99).
“[W]hile existing data support that palliative care is not harmful, perhaps there is a time when palliative care — particularly provided by specialists — is less likely to be as helpful,” the researchers wrote. “It is plausible that patients with newly diagnosed cancer pursuing curative-intent surgery were too early in their cancer trajectory for specialist palliative care to have a measurable benefit.”
Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Aslakson RA, Rickerson E, Fahy B, et al. Effect of perioperative palliative care on health-related quality of life among patients undergoing surgery for cancer: A randomized clinical trial. JAMA Netw Open. Published online May 31, 2023. doi:10.1001/jamanetworkopen.2023.14660
