title: Outpatient Palliative Care and Aggressiveness of End-of-Life Care in Patients with Metastatic Colorectal Cancer.
abstract: BACKGROUND
  Palliative care in outpatient setting has been shown to promote better symptom management and transition to hospice care among patients with advanced cancer. Nevertheless, specialized palliative care is rarely provided at cancer centers in Korea. Herein, we aimed to assess aggressiveness of end-of-life care for patients with metastatic colorectal cancer according to the use of outpatient palliative care (OPC) at a single cancer center in Korea.
  
  
  METHODS
  We performed a retrospective medical record review for 132 patients with metastatic colorectal cancer who died between 2011 and 2014. Fifty patients used OPC (OPC group), while 82 patients did not (non-OPC group). Indicators of aggressiveness of end-of-life care including chemotherapy use, emergency department visits, hospitalization, and utilization of hospice care were analyzed according to the use of OPC.
  
  
  RESULTS
  More patients in the OPC group were admitted to hospice than those in the non-OPC group (32% vs 17%, P = .047). The mean of inpatient days within 30 days of death was shorter for the OPC group than the non-OPC group (4.02 days vs 7.77 days, respectively, P = .032). There were no differences in the proportions of patients who received chemotherapy and visited the emergency department within 30 days from death.
  
  
  CONCLUSIONS
  Among patients with metastatic colorectal cancer, OPC was associated with shorter inpatient days near death and greater hospice utilization. Further prospective studies are needed to evaluate the impact of OPC on end-of-life care in Korea.
authors.affiliation: 1 Department of Internal Medicine, National Cancer Center, Goyang, Korea.|2 Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Si Won
authors.initials: SW
authors.lastname: Lee
authors.affiliation: 3 Department of Hospice & Palliative Service, National Cancer Center, Goyang, Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Jho
authors.affiliation: 1 Department of Internal Medicine, National Cancer Center, Goyang, Korea.|4 Center for Colorectal Cancer, National Cancer Center, Goyang, Korea. Sun Young Kim is now with Department of Oncology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Baek
authors.affiliation: 4 Center for Colorectal Cancer, National Cancer Center, Goyang, Korea. Sun Young Kim is now with Department of Oncology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Shim
authors.affiliation: 4 Center for Colorectal Cancer, National Cancer Center, Goyang, Korea. Sun Young Kim is now with Department of Oncology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
authors.forename: Hyun Mi
authors.initials: HM
authors.lastname: Kim
authors.affiliation: 4 Center for Colorectal Cancer, National Cancer Center, Goyang, Korea. Sun Young Kim is now with Department of Oncology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Ku
authors.affiliation: 3 Department of Hospice & Palliative Service, National Cancer Center, Goyang, Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Nam
authors.affiliation: 3 Department of Hospice & Palliative Service, National Cancer Center, Goyang, Korea.
authors.forename: Yoon-Jung
authors.initials: YJ
authors.lastname: Chang
authors.affiliation: 2 Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Choi
authors.affiliation: 1 Department of Internal Medicine, National Cancer Center, Goyang, Korea.|4 Center for Colorectal Cancer, National Cancer Center, Goyang, Korea. Sun Young Kim is now with Department of Oncology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Kim
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002173:Cancer Care Facilities / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000628:therapy*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D017051:Hospice Care / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D056910:Republic of Korea; D012189:Retrospective Studies; D013727:Terminal Care / Q000706:statistics & numerical data*
chemical_list: D000970:Antineoplastic Agents
keywords: colorectal neoplasms; outpatient clinics; palliative care; palliative medicine; palliative treatment; terminal care