1439 - Changes in symptom intensities among cancer patients receiving outpatient palliative care

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Palliative Care
Presenter Jung Hun Kang
Authors J.H. Kang1, D. Hui2, Y. Sriram3, J.H. Kwon3, E. Bruera3
  • 1Internal Medicine, Gyeongsang University Hospital, 660-702 - Jinju/KR
  • 2Palliative Care And Rehabilitory Medicine, M.D. Anderson Cancer Center, 77030 - Houston/US
  • 3Palliative Care And Rehabilitation Medicine, M.D. Anderson Cancer Center, 77030 - Houston/US



Symptom changes are usually reported using summary statistics such as mean and/or median. The main objective of this retrospective study was to determine the magnitude of symptom changes as assessed by the Edmonton Symptom Assessment System (ESAS) after outpatient palliative care (OPC) at the first follow-up visit.


We reviewed 1612 consecutive patients who were referred to the outpatient Supportive Care Center and who completed the ESAS at initial and first follow-up visits between January 2003 and December 2010. All patients received interdisciplinary care led by palliative care specialists following an institutional protocol.


The distribution of the magnitude of symptom changes was stratified by baseline intensities. Patterns were similar for different ESAS items. At the follow-up visit, 52% to 74% of patients achieved symptom improvement by >= 1 point. However, 48% to 80% of patients with moderate/severe intensity at baseline complained of symptoms with ESAS score >= 4 after OPC. Symptoms with absent/mild intensity worsened ranging from mean of -3.04 to 0.12 at the first follow-up visit, whereas symptoms with moderate/severe intensity improved from -0.2 to 3.86(p < 0.001).


Considerable patients with moderate or severe intensity at the baseline still had symptoms with ESAS score >= 4. Patients with absent/mild intensities at baseline complained of symptom exacerbation at the first follow-up visit. Various strategies are needed to optimize symptom control in advanced cancer.


All authors have declared no conflicts of interest.