Post-Discharge Survival Outcomes of Patients with Advanced Cancer from the University of Texas MD Anderson Cancer Center Investigational Cancer Therapeutics (Phase I Trials) Inpatient Unit.
BACKGROUND
Patients with advanced cancer who progress on standard therapy are potential candidates for phase I clinical trials. Due to their aggressive disease and complex comorbid conditions, these patients often need inpatient admission. This study assessed the outcomes of such patients after they were discharged to hospice care.


METHODS
We performed a retrospective analysis of patients with solid tumor malignancies who were discharged to hospice care from the inpatient service.


RESULTS
One hundred thirty-three patients were included in the study cohort. All patients had metastatic disease and an Eastern Cooperative Oncology Group performance status ≥3. The median survival after discharge to hospice from an inpatient setting was 16 days, with a survival rate of 5% at 3 months after discharge. The median survival after the last cancer treatment was 46 days, with survival of 17% at 3 months, and 5% at 6 months. Patients with lactate dehydrogenase (LDH) >618 IU/L had a median post-discharge survival of 11 days versus 20 days for patients with LDH ≤618 IU/L.


CONCLUSIONS
Patients with metastatic cancer participating in phase I trials who have poor performance status and require inpatient admission have a very short survival after discharge to hospice. A high LDH level predicts an even shorter survival.
Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Holly
H
Kinahan
Abhishek
A
Maiti
Kenneth
K
Hess
Jennifer
J
Dempsey
Laura
L
Beatty
Sarah
S
Baldwin
David S
DS
Hong
Aung
A
Naing
Siqing
S
Fu
Apostolia M
AM
Tsimberidou
Sarina
S
Piha-Paul
Filip
F
Janku
Daniel
D
Karp
Suresh
S
Reddy
Sriram
S
Yennu
Daniel
D
Epner
Eduardo
E
Bruera
Funda
F
Meric-Bernstam
Gerald
G
Falchook
Vivek
V
Subbiah
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017321:Clinical Trials, Phase I as Topic / Q000706:statistics & numerical data*; D005260:Female; D017051:Hospice Care / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013781:Texas / Q000453:epidemiology; D055815:Young Adult