title: Palliative Care for Patients with Gynecologic Cancer in Japan:
  A Japan Society of Gynecologic Palliative Medicine (JSGPM)
  Survey
abstract: Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A
  questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care,
  provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer,
  was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded
  to the questionnaire. Of these, 33.0 (29.0%) had a palliative care ward. End-of-life care was managed by obstetricians
  and gynecologists in 72.0% of the facilities. The site where end-of-life care was provided was most often a ward in the
  department where the respondent worked. The waiting period for transfer to a hospice was 2 weeks or more in 52% of
  facilities. Before the start of primary treatment, pain control was managed by obstetrians and gynecologists in 98.0% of
  facilities. Palliative radiation therapy or chemotherapy was administered at 93.9% and 92.0% of facilities, respectively.
  Of the 115 facilities, 34.0 (29.6%) reported cases of death from gynecological cancer. There were 1,134 cases of death.
  The median time between the last cycle of chemotherapy and death was 85 days for all gynecological cancers. The
  proportion of patients receiving chemotherapy in the last 30 and 14 days of life were 17.4% and 7.1%, respectively.
  Conclusions: This large-scale survey showed characteristics of palliative care given to patients with gynecologic
  cancer in Japan. Assessment of death cases showed that the median time between the last cycle of chemotherapy and
  death was relatively short.
authors.affiliation: Department of Obstetrics and Gynecology and 2Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5-Zaifu-cho, Hirosaki, Aomori 036-8562, Japan. Email: futagami@hirosaki-u.ac.jp
authors.forename: Masayuki
authors.initials: M
authors.lastname: Futagami
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Tetsumi
authors.initials: T
authors.lastname: Sato
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Hirota
authors.forename: Muneaki
authors.initials: M
authors.lastname: Shimada
authors.forename: Etsuko
authors.initials: E
authors.lastname: Miyagi
authors.forename: Nao
authors.initials: N
authors.lastname: Suzuki
authors.forename: Masaki
authors.initials: M
authors.lastname: Fujimura
keywords: Palliative care; gynecologic cancer; palliative chemotherapy; anonymous questionnaire; death cases