1695MO - Cancer care during armed conflict: Factors associated with adult patient transfer for treatment abroad during the war in Ukraine

Background

Because of Russian Federation’s invasion of Ukraine, many patients with cancer are unable to receive treatment at home. We explored factors associated with transfer of cancer patients to the European Union (EU) for treatment through the joint program.

Methods

We conducted a retrospective review of data from the Ministry of Health (MOH) on patients who applied to be transferred abroad for cancer care from April 2022 to April 2023. Data was analyzed using descriptive statistics and standard tests of association.

Results

336 (53.0%) of 634 patients were analyzed. We excluded children, patients without a cancer and with no available data. The mean age was 46.9 years (SD 土 13.5). 197 (58.6%) had ECOG 0-1, 94 (30%) ECOG 2, 14 (4.2%) ECOG 3-4, 31 (9.2%) ECOG unknown. The most common cancers were: 102 (30.4%) melanoma, 43 (12.8%) breast cancer, 31 (9.2%) chronic hematologic and 26 (7.8%) acute hematologic malignancies, 21 (6.3%) colorectal cancer, 20 (6.0%) lung cancer, 12 (3.6%) head and neck cancer. Of 336 patients, 280 (83.3%) were transferred for care abroad, 22 (6.5%) were pending, 28 (8.3%) transfers declined. Reasons for transfer were treatment not available, new diagnosis190 (56.5%), 105 (31.3%) for continuation of care, 19 (5.6%) cancer relapse, 32 (9.5%) bone marrow transplant, 15 (4.5%) radiotherapy, 13 (3.9%) surgery, 3 (0.9%) organ transplant. Factors independently associated with being transferred were breast cancer (OR 5.8, 95% CI: 2.7-5.7), melanoma (OR 2.6, 95% CI: 1.2-5.6), ECOG 3-4 (OR 0.1, 95% CI: 0.01-0.4). In univariate analysis, not having cancer treatment available in Ukraine (OR 2.5, 95% CI: 1.4-4.5), head and neck cancer (OR 0.2, 95% CI: 0.1- 0.6), and continuation of cancer care when drug was not available in Ukraine (OR 2.5, 95% CI: 1.4-4.5) were also associated with transfer.

Conclusions

The Ukraine-EU program for transferring cancer patients abroad is a strategy to mitigate issues with cancer care capacity during armed conflict, with almost all patients who applied currently receiving cancer treatment in the EU. Patient-related factors associated with transfer abroad for cancer care during war included patient condition, cancer type, and government treatment coverage.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.