title: Palliative care units in lung cancer in the real-world setting: a single institution's experience and its implications.
abstract: OBJECTIVE
  Palliative care plays a crucial role in the overall management of patients with advanced lung cancer and was shown to lead to clinically meaningful improvement in quality of life, less aggressive endof-life care, and potentially prolonged survival. Here we summarize our single institution experience on palliative care in patients with lung cancer.
  
  
  METHODS
  The data of patients with lung cancer treated at the palliative care unit of the Medical University of Vienna between June 2010 and March 2013 were retrospectively reviewed. Patient characteristics, reasons for admissions, treatment as well as interventions during hospitalization, and clinical outcomes were determined.
  
  
  RESULTS
  The study enrolled 91 lung cancer patients, who represented 19.8% of the 460 patients admitted to the palliative care unit. They had the following clinical characteristics: 39% females, 61% males; median age 62 years; median Karnofsky performance status 50%, 92% metastatic disease, 74% non-small cell lung cancer (NSCLC), 19% small-cell lung cancer (SCLC), 7% neuroendocrine carcinomas of the lung. Primary reasons for admission were deterioration of performance status in 40%, uncontrolled cancer-related pain in 38%, dyspnea in 13%, and psychosocial factors in 8% of the patients. Median duration of hospitalization was 16 days (range, 1-101 days). Improvement or stabilisation of tumor-related symptoms was achieved in 25% of the patients. Seventy-five percent of all patients died during their first admission. Their median survival from primary diagnosis until death was 16 months (95% confidence interval, 13.7-18.3 months).
  
  
  CONCLUSIONS
  Patients with lung cancer admitted to the palliative care unit had late-stage disease. In order to provide early palliative care, the management of lung cancer patients should guarantee access to ambulatory care, inpatient care and home care as well as cooperation and communication between oncologists and palliative care physicians.
authors.affiliation: Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria. eva.masel@meduniwien.ac.at.
authors.forename: Eva Katharina
authors.initials: EK
authors.lastname: Masel
authors.affiliation: Clinical Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Sophie
authors.initials: S
authors.lastname: Schur
authors.affiliation: Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Romina
authors.initials: R
authors.lastname: Nemecek
authors.affiliation: Clinical Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Mayrhofer
authors.affiliation: Clinical Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Huber
authors.affiliation: Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Feroniki
authors.initials: F
authors.lastname: Adamidis
authors.affiliation: Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Bruno
authors.initials: B
authors.lastname: Maehr
authors.affiliation: Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Unseld
authors.affiliation: Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Herbert Hans
authors.initials: HH
authors.lastname: Watzke
authors.affiliation: Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria.
authors.forename: Robert
authors.initials: R
authors.lastname: Pirker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000556:secondary / Q000628:therapy; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy; D000072716:Cancer Pain / Q000209:etiology / Q000628:therapy*; D018278:Carcinoma, Neuroendocrine / Q000150:complications / Q000556:secondary / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000556:secondary / Q000628:therapy*; D019468:Disease Management; D004417:Dyspnea / Q000209:etiology / Q000628:therapy*; D005260:Female; D006757:Hospital Units; D006801:Humans; D017567:Karnofsky Performance Status; D007902:Length of Stay; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011788:Quality of Life; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000150:complications / Q000556:secondary / Q000628:therapy*; D013727:Terminal Care
keywords: Dyspnea; interdisciplinary communication; lung neoplasms; palliative care; symptom assessment; terminal care