Continuous deep sedation (CDS) does not shorten life and should be considered a viable option for patients with advanced cancer being cared for in a palliative setting, according to a study published online ahead of print in The Lancet Oncology.1
CDS as a form of palliative care has been the subject of debate. Investigators sought to determine whether CDS shortened survival and to establish the effects of artificial hydration.
This study was part of a secondary analysis of a large multicentre prospective cohort study that recruited and followed-up patients between Sept 3, 2012, and April 30, 2014.
Patients age 20 years and older with advanced cancer who received care through the participating palliative care services were eligible. Investigators compared survival between patients who received CDS with those who did not. A propensity score-weighting method was used to control for patient characteristics, disease status, and symptom burden.
The team of Japanese investigators analyzed data from 1827 patients, 269 (15%) of which received CDS. Results showed unweighted median survival of 27 days (95% CI, 22 – 30) in the CDS group vs 26 days in the no-CDS group.
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Following propensity-score weighting, median survival for those in the CDS group was 22 days for patients receiving CDS vs 26 days for patients without CDS (95% CI, 0.87 – 1.17; log-rank P = .91). Volume of artificial hydration had no effect on the association between sedation and survival.
- Maeda I, Morita T, Yamaguchi T, et al. Effect of continuous deep sedation on survival in patients with advanced cancer (J-Proval): a propensity score-weighted analysis of a prospective cohort study [published online ahead of print November 20, 2015]. Lancet Oncol. doi: 10.1016/S1470-2045(15)00401-5.