Current management strategies of cancer patients are adopting multidisciplinary meetings (MDM) and including the earliest palliative care intervention to improve the quality of life and survival. We have established, since 2015, a monthly onco-palliative care MDM for the management of our cancer patients. This study reports on the role of onco-palliative MDM in Hotel Dieu de France University Hospital, an ESMO Designated Center of Integrated Oncology and Palliative Care.
All cancer patients referred to the mobile palliative care unit and/or transferred to the palliative care unit, are presented and discussed during the onco-palliative care MDMs held between May 2015 and November 2017. Demographic, clinical and long-term characteristics were obtained from the electronic medical records and retrospectively nalysed. Demographic and survival data were compared between 2015 and 2017.
245 patients were presented during 20 MDMs. Median age was 68 years (range 59-77) and 58% of patients were male. The most common motive for palliative care consultation was social support (40%). Over the study period, no significant effect on the place of death was retained. However, patients had significant improvement in the symptomatic management of their disease between 2015 and 2017 (41.6% vs 7% in 2015) and better social support (60.7% vs 32.4% in 2015) (p < 0.0001). The median survival of patients after the onco-palliative care MDMS was 23 days (19.3- 26.7). No significant difference in survival was noted over the 3 year course (p = 0.315). Using the univariate cox regression model, in comparison to 2015, the hazard ratio is 0.780 (0.556 – 1.094, p = 0.149) for 2016, and 0.924 (0.3652 – 1.309, p = 0.656) for 2017.
The onco-palliative care MDMs is an innovative approach in Lebanon, a small conservative Middle Eastern society. These MDMs were shown to improve the quality of life of cancer patients with better symptomatic and social support. However, no significant impact on survival was demonstrated so far.
Clinical trial identification
Legal entity responsible for the study
Saint Joseph University.
Has not received any funding.
All authors have declared no conflicts of interest.