Evaluation of Ovarian Cancer Care at the End of Life in a Single Tertiary Hospital

Aim: Fundamentally, aggressive care is considered to be avoided for the patients\r\nat the end of life. However, this is not always adhered in real-world practice.\r\nWe attempted to determine whether, and if so how, the aggressive care is made\r\nfor patients with ovarian cancer during the last month prior death. Methods: Enrolled were a total of 104\r\npatients with ovarian cancer (including fallopian tube or primary peritoneal\r\ncancer), who were treated in Kuopio University Hospital in Finland during\r\n2009-2014. The aggressive care was defined according to the standards outlined\r\nby the National Quality Forum; shortly, chemotherapy,\r\nemergency-room/intensive-care visit/admission, hospital admission, and death in\r\nhospital. Results: Two thirds of patients (67%) had received at least one form of\r\naggressive care during the last month of their lives. Especially, admission in\r\nhospital in the last 30 days of life was the most common form of aggressive\r\ncancer care. Younger patients ( = 0.004). Those women that underwent end-of-life discussions earlier than\r\none month prior to death had significantly less aggressive care than those\r\nwomen that had discussions during the last month (48% vs. 90%, p = 0.001). Conclusions: Ovarian\r\ncancer patients received commonly at least one form of aggressive care at the\r\nend of their lives. More efforts should be taken to improve the quality of\r\npalliative and end-of-life care.