Quality of end of life care in adolescent and young adults with cancer in Japan

Quality of end of life care in adolescent and young adults with cancer in Japan

Tsumura A; Noguchi-Abe K; Ishida Y

Supportive Care in Cancer

2018

soft tissue; adolescent; major clinical study; retrospective study; cancer patient; cancer chemotherapy; cancer diagnosis; health care personnel; medical record; time of death; conference abstract; human; female; male; adult; terminal care; young adult; palliative therapy; Japan; brain; solid malignant neoplasm; bone; emergency care

Introduction About 4% of all cancers occur in adolescent and young adults (AYA) population in Japan. Quality and intensity of end-of-life (EOL) care in this population vary among different nationalities or cultures. Objectives We aimed to evaluate quality of EOL care in Japanese AYA patients. Methods We retrospectively reviewed electric medical record of AYA patients died from Jan 2013 to Dec 2017 in our hospital. Patients were eligible if they were aged 15-39 years at the time of death. Results A total of 114AYA patients were reviewed. These patients were consisted of 50 men (44%) and 64 women (56%). Median age (interquartile range) was 32 (28-34) years. Cancer types included bone/soft tissue (n=23, 20%), brain (n=10, 9%), hematological (n=5, 4%), and other solid tumor (n=76, 67%). Most patients were informed of their cancer diagnosis and disease condition when they started treatment. However, preference of EOL care was discussed in 37 (33%) of patients before the last 30 days of life. 23 patients (20%) received chemotherapy during the last 14 days of life. 6 (5%), 19 (17%), and 82 (72%) patients died at home, palliative care unit, and acute care unit, respectively. Median days spent at home in the last 30 days of life was 5 (0-17) days. Conclusions There was a little population who could discuss EOL care in advance based on AYA patients' wishes. Better understanding of EOL care is needed in both health care providers and care givers to improve quality of EOL care in AYA population.

Oncology 2018 List