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Study on the Impact of Location of Advanced Cancer Patients on Their Survival

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Researchers at the University of Tsukuba conducted a study to compare the difference between the survival times of patients with advanced cancer who stayed at home with those who stayed in a palliative care unit. Results showed that there was little difference. However, patients who stayed at home may have a slightly longer prognosis even after considering the impact of the treatment and care received at each location.

Tsukuba, Japan—The location where cancer patients spend their last time can affect their "quality of death." However, it remains unclear whether the location along with the received treatment and care can affect their survival. Therefore, herein, we investigated if there is a difference between the survival of advanced cancer patients who received treatment and care at home (home group) and those who received treatment and care in a palliative care ward (palliative care ward group).

Herein, we conducted a study on the effect of the location where the patient spends the last hours of life on survival. The patients' physical conditions and symptoms at the time treatment and care started at home or in a palliative care ward, symptoms until death, and received treatment and care were considered. Results showed that the survival time was considerably longer in the home group than in the palliative care ward group when the prognosis was expected in months or weeks, according to PiPS-A, an objective prognostic indicator. However, there was no considerable difference in survival time based on the location when the prognosis was expected in days.

Notably, this study did not consider symptoms before death and how the received treatment and care changed and affected survival. Therefore, we cannot conclude here that people live longer at home. Nonetheless, the findings can be used to reassure clinicians, patients, and families that spending the final hours at home is unlikely to shorten survival.

Funding Source This EASED study was partly supported by a Grant-in-Aid from the Japanese Hospice Palliative Care Foundation. This COME Home study was partly supported by JSPS KAKENHI Grant Numbers 19K10551 and 22H03305. The sponsor played no role in the study design, collection, analysis, or interpretation of the data, writing the report, or submitting the paper for publication.

Original Paper

Title of original paper:
Comparison of survival times of advanced cancer patients with palliative care at home and in hospital


Assistant Professor HAMANO Jun
Institute of Medicine, University of Tsukuba

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