1349P - A simultaneous approach to care: An Italian Tertiary Cancer Center Experience

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Supportive and Palliative Care
Presenter Maria Simona Pino
Citation Annals of Oncology (2014) 25 (suppl_4): iv471-iv477. 10.1093/annonc/mdu350
Authors M.S. Pino1, S. Zoccali2, E. Magnani3, F. Ciappi4, L. Iozzi2, F. Leoni2, L. Fioretto1, A.S. Ribecco3
  • 1Oncology, Medical Oncology Unit 1, AUSL 10 FIRENZE, 50122 - FLORENCE/IT
  • 2Oncology, Palliative Care Unit (supported By F.i.l.e., Leniterapia Italian Foundation), AUSL 10 FIRENZE, 50122 - FLORENCE/IT
  • 3Oncology, Medical Oncology Unit 2, AUSL 10 FIRENZE, 50122 - FLORENCE/IT
  • 4Oncology Department, Medical Oncology Unit 2, AUSL 10 FIRENZE, 50143 - FIRENZE/IT



In the last decade an increasing number of scientific evidence has confirmed that an early integration of palliative medicine into routine oncological care, or simultaneous care approach, ensures the best results in terms of quantity and quality of life, and performance of antitumor therapy for advanced cancer patients. To determine the outcome of an integrated oncology and palliative care approach in a real-world clinical practice setting in Italy.


Since January 2011 the Oncology Department at the Local Health Authority (AUSL) 10, in Florence (Tuscany region), has been working in cooperation with the Palliative Care Unit to ensure early integration of palliative cancer care for patients with advanced solid tumors or hematological malignancies, and a prognosis of one year or less to live. We performed a retrospective medical record review of all the patients followed by the simultaneous care team between January 2011 and December 2013. Here we present a preliminary analysis.


From January 2012 to December 2013, 260 patients received simultaneous assistance by the oncologists and the palliative care providers. Among these patients, 131 (51%) were female and 129 (49%) were male, with a median age of 69 (range 38 to 87 years) and 73 (range 36 to 90 years), respectively. Half of the patients had advanced gastrointestinal (31%) or lung cancer (28%). 691 and 1051 visits were performed in 2012 and 2013, respectively. The length of simultaneous care increased from an average of 70 days in 2012 to 132 days in 2013 (P = 0.0012). A significant difference by sex was observed, with longer simultaneous care duration among women (P = 0.041). In 2012 53 patients out of 62 (85%) died at home or in hospice, in 2013 116 patients out of 125 (93%). A significant difference in place of death by age was observed, with older patients more frequently dying in hospital (P = 0.026).


Our data show that an early integration of palliative services allows developing an adequate home- or hospice-base care plan, improving patient's quality of life and family distress. We will present the full clinical data at the meeting.


All authors have declared no conflicts of interest.