A NATION-WIDE ANALYSIS OF PALLIATIVE CARE USE IN PATIENTS WITH METASTATIC PENILE CANCER

You have accessJournal of UrologyPenile & Testicular Cancer: Penile & Testicular Cancer III (MP76)1 Apr 2020MP76-06 A NATION-WIDE ANALYSIS OF PALLIATIVE CARE USE IN PATIENTS WITH METASTATIC PENILE CANCER Facundo Davaro*, Allison May, Johar Syed, Sameer Siddiqui, and Zachary Hamilton Facundo Davaro*Facundo Davaro* More articles by this author , Allison MayAllison May More articles by this author , Johar SyedJohar Syed More articles by this author , Sameer SiddiquiSameer Siddiqui More articles by this author , and Zachary HamiltonZachary Hamilton More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000962.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Advanced penile cancer is associated with a poor prognosis; therefore, providing patients with realistic expectations, addressing goals of care and offering palliative therapy when appropriate is critical. Our goal was to investigate the National Cancer Database (NCDB) and analyze the role and trends in use of palliative therapy in patients with metastatic penile cancer. METHODS: The NCDB 2004−2015 penile cancer dataset was queried for patients with metastatic disease regardless of tumor or nodal stage. Patients were categorized based on receipt of palliative care. Palliative care was catalogued as pain management therapy, surgery, radiation or systemic treatment, any combination therapy or not otherwise specified (NOS). Our primary outcome was receiving palliative therapy. Secondary outcome was the temporal trends in palliative care. Logistic regression (LR) was performed. RESULTS: 279 patients were identified with metastatic penile cancer with 49 (17.6%) of those receiving palliative care. Average age of patients accepting palliative care was 61.9 years old, about five years younger than those who declined therapy (p <0.011). Other patient specific demographics and clinical tumor characteristics were not significantly different between the two cohorts. Radiation (32.7%) and systemic therapy (24.5%) were the most prevalent choices for palliative treatment followed by combination treatment (16.3%), surgery (12.2%), pain management (10.2%), or NOS (4.1%). LR for the receipt of “any palliative therapy” revealed that increasing age (OR 0.971, p=0.032) decreased the likelihood of accepting palliative therapy. Meanwhile, African-American race (OR 2.502, p=0.025), Charlson score 1 (2.175, p=0.047) and 3+ (5.386, p=0.020) predicted an increased predilection for receiving palliative therapy. No statistically significant difference in mortality was noted between cohorts. No significant increase in the trend of palliative care administration was seen between 2004 to 2015 (p=0.942). CONCLUSIONS: Metastatic penile cancer carries a high mortality rate yet only 17.9% of patients receive palliative care. Its use is more common in younger patients, those with co-morbidities and/or those of black race. Receipt of palliative care did not increase mortality. No changes in the frequency of use were seen. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1153-e1153 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Facundo Davaro* More articles by this author Allison May More articles by this author Johar Syed More articles by this author Sameer Siddiqui More articles by this author Zachary Hamilton More articles by this author Expand All Advertisement PDF downloadLoading ...