Real-World Study Shows Palliative Care Benefits Young Colorectal Cancer Patients at End-of-Life
核心洞察
A real-world analysis of 4,060 early-onset colorectal cancer (搜索) patients reveals palliative care significantly reduced invasive interventions and hospital costs during end-of-life care.
Patients receiving palliative care showed lower rates of mechanical ventilation (20.4% vs 43.4%), blood transfusions (14.8% vs 22.6%), and vasopressor use (6.2% vs 8.6%) compared to standard care.
Integration of palliative care led to substantial cost savings, with median hospital charges reduced by approximately $32,000 per patient, while increasing DNR order rates from 44.6% to 83.3%.
A new real-world study presented at the 2025 ASCO (搜索) Gastrointestinal Cancer Symposium demonstrates significant benefits of palliative care integration for younger patients with advanced colorectal cancer (搜索), particularly in improving end-of-life comfort and reducing unnecessary interventions.
Significant Reduction in Invasive Interventions
The study analyzed 4,060 hospital admissions between 2016 and 2020, comparing outcomes between patients who received palliative care (n=2,425) and those who did not (n=1,635). All patients were under 50 years old with early-onset colorectal cancer (搜索) who died during admission.
The palliative care group showed markedly lower rates of invasive interventions:
- Mechanical ventilation: 20.4% vs 43.4% (P <.001)
- Blood transfusions: 14.8% vs 22.6% (P <.001)
- Vasopressor use: 6.2% vs 8.6% (P =.004)
Cost and Care Management Implications
The financial impact was substantial, with palliative care involvement reducing median hospital charges from $131,993 to $99,367 (P <.001). Additionally, do-not-resuscitate (DNR) orders increased significantly from 44.6% to 83.3% in the palliative care group (P <.001).
"Inclusion of palliative care in terminal hospital stays for patients with early-onset CRC (搜索) was associated with less use of invasive and uncomfortable interventions, resulting in significantly reduced expenditure on futile measures," stated Dr. Suriya Baskar, resident physician at the Brooklyn Hospital Center (搜索).
Patient Demographics and Hospital Stay Characteristics
The study populations were well-matched, with median ages of 42.1 and 41.9 years for the palliative care and non-palliative care groups, respectively. Female representation was slightly higher in the palliative care group (44.3% vs 39.8%, P =.004). Charlson Comorbidity Index scores were comparable between groups (8.6 vs 8.3, P <.001).
Length of hospital stay remained similar between groups (8.8 days with palliative care vs 9.1 days without, P =.38), and chemotherapy utilization was nearly identical at approximately 2.9% in both cohorts.
Context Within Broader Palliative Care Research
These findings build upon previous research demonstrating palliative care benefits in elderly cancer patients. A recent JAMA Network (搜索) Open study showed that early palliative care intervention improved quality of life at 18 months and enhanced existential well-being. Notably, patients receiving frequent early palliative care consultations (10 or more times) demonstrated significantly improved two-year overall survival rates.