Palliative care delivery according to age in 12,000 women with metastatic breast cancer: Analysis in the multicentre ESME-MBC cohort 2008–2016
Patients with metastatic breast cancer (MBC) often require inpatient palliative care (IPC). However, mounting evidence suggests age-related disparities in palliative care delivery. This study aimed to assess the cumulative incidence function (CIF) of IPC delivery, as well as the influence of age. Th...
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| Veröffentlicht in: | European journal of cancer (1990) 2020-09, Vol.137, p.240-249 |
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| creator | Frasca, Matthieu Sabathe, Camille Delaloge, Suzette Galvin, Angeline Patsouris, Anne Levy, Christelle Mouret-Reynier, Marie A. Desmoulins, Isabelle Vanlemmens, Laurence Bachelot, Thomas Goncalves, Anthony Perotin, Virginie Uwer, Lionel Frenel, Jean S. Ferrero, Jean M. Bouleuc, Carole Eymard, Jean C. Dieras, Véronique Leheurteur, Marianne Petit, Thierry Dalenc, Florence Jaffre, Anne Chevrot, Michaël Courtinard, Coralie Mathoulin-Pelissier, Simone |
| description | Patients with metastatic breast cancer (MBC) often require inpatient palliative care (IPC). However, mounting evidence suggests age-related disparities in palliative care delivery. This study aimed to assess the cumulative incidence function (CIF) of IPC delivery, as well as the influence of age.
The national ESME (Epidemio-Strategy-Medical-Economical)-MBC cohort includes consecutive MBC patients treated in 18 French Comprehensive Cancer Centres. ICD-10 palliative care coding was used for IPC identification.
Our analysis included 12,375 patients, 5093 (41.2%) of whom were aged 65 or over. The median follow-up was 41.5 months (95% confidence interval [CI], 40.5–42.5). The CIF of IPC was 10.3% (95% CI, 10.2–10.4) and 24.8% (95% CI, 24.7–24.8) at 2 and 8 years, respectively. At 2 years, among triple-negative patients, young patients ( |
| doi_str_mv | 10.1016/j.ejca.2020.07.007 |
| format | Article |
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The national ESME (Epidemio-Strategy-Medical-Economical)-MBC cohort includes consecutive MBC patients treated in 18 French Comprehensive Cancer Centres. ICD-10 palliative care coding was used for IPC identification.
Our analysis included 12,375 patients, 5093 (41.2%) of whom were aged 65 or over. The median follow-up was 41.5 months (95% confidence interval [CI], 40.5–42.5). The CIF of IPC was 10.3% (95% CI, 10.2–10.4) and 24.8% (95% CI, 24.7–24.8) at 2 and 8 years, respectively. At 2 years, among triple-negative patients, young patients (<65 yo) had a higher CIF of IPC than older patients after adjusting for cancer characteristics, centre and period (65+/<65: β = −0.05; 95% CI, −0.08 to −0.01). Among other tumour sub-types, older patients received short-term IPC more frequently than young patients (65+/<65: β = 0.02; 95% CI, 0.01 to 0.03). At 8 years, outside large centres, IPC was delivered less frequently to older patients adjusted to cancer characteristics and period (65+/<65: β = −0.03; 95% CI, −0.06 to −0.01).
We found a relatively low CIF of IPC and that age influenced IPC delivery. Young triple-negative and older non-triple-negative patients needed more short-term IPCs. Older patients diagnosed outside large centres received less long-term IPC. These findings highlight the need for a wider implementation of IPC facilities and for more age-specific interventions.
•Age was an independent factor of inpatient palliative care (IPC) delivery in metastatic breast cancer (MBC) patients.•This association depended on the tumour sub-type and the centre activity.•Young HER2-/HR- and older non-triple-negative patients needed more short-term IPC.•Older patients diagnosed in large centres more frequently received long-term IPC.•A wider implementation of IPC might improve access for older MBC patients.</description><identifier>ISSN: 0959-8049</identifier><identifier>EISSN: 1879-0852</identifier><identifier>DOI: 10.1016/j.ejca.2020.07.007</identifier><identifier>PMID: 32805641</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Age ; Age Factors ; Aged ; Breast cancer ; Breast Neoplasms - rehabilitation ; Cancer ; Cohort Studies ; Confidence intervals ; Female ; History, 21st Century ; Humans ; Inpatient care ; Life Sciences ; Metastases ; Metastasis ; Metastatic breast cancer ; Neoplasm Metastasis ; Palliation ; Palliative Care ; Palliative medicine ; Tumors</subject><ispartof>European journal of cancer (1990), 2020-09, Vol.137, p.240-249</ispartof><rights>2020 Elsevier Ltd</rights><rights>Copyright © 2020 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Sep 2020</rights><rights>Attribution - NonCommercial</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-eefa1aee057fc6fbb50a2c1c23b24cf3c6d0f0d58562888097626b993b3a21fe3</citedby><cites>FETCH-LOGICAL-c462t-eefa1aee057fc6fbb50a2c1c23b24cf3c6d0f0d58562888097626b993b3a21fe3</cites><orcidid>0000-0003-0572-5222 ; 0000-0002-0866-9484 ; 0000-0001-9353-691X ; 0000-0001-7799-1648 ; 0000-0001-7570-7439 ; 0000-0002-8746-0725 ; 0000-0001-5542-5813 ; 0000-0001-6981-1678 ; 0000-0003-2106-9165</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0959804920303907$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27903,27904,65308</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32805641$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-02995511$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Frasca, Matthieu</creatorcontrib><creatorcontrib>Sabathe, Camille</creatorcontrib><creatorcontrib>Delaloge, Suzette</creatorcontrib><creatorcontrib>Galvin, Angeline</creatorcontrib><creatorcontrib>Patsouris, Anne</creatorcontrib><creatorcontrib>Levy, Christelle</creatorcontrib><creatorcontrib>Mouret-Reynier, Marie A.</creatorcontrib><creatorcontrib>Desmoulins, Isabelle</creatorcontrib><creatorcontrib>Vanlemmens, Laurence</creatorcontrib><creatorcontrib>Bachelot, Thomas</creatorcontrib><creatorcontrib>Goncalves, Anthony</creatorcontrib><creatorcontrib>Perotin, Virginie</creatorcontrib><creatorcontrib>Uwer, Lionel</creatorcontrib><creatorcontrib>Frenel, Jean S.</creatorcontrib><creatorcontrib>Ferrero, Jean M.</creatorcontrib><creatorcontrib>Bouleuc, Carole</creatorcontrib><creatorcontrib>Eymard, Jean C.</creatorcontrib><creatorcontrib>Dieras, Véronique</creatorcontrib><creatorcontrib>Leheurteur, Marianne</creatorcontrib><creatorcontrib>Petit, Thierry</creatorcontrib><creatorcontrib>Dalenc, Florence</creatorcontrib><creatorcontrib>Jaffre, Anne</creatorcontrib><creatorcontrib>Chevrot, Michaël</creatorcontrib><creatorcontrib>Courtinard, Coralie</creatorcontrib><creatorcontrib>Mathoulin-Pelissier, Simone</creatorcontrib><title>Palliative care delivery according to age in 12,000 women with metastatic breast cancer: Analysis in the multicentre ESME-MBC cohort 2008–2016</title><title>European journal of cancer (1990)</title><addtitle>Eur J Cancer</addtitle><description>Patients with metastatic breast cancer (MBC) often require inpatient palliative care (IPC). However, mounting evidence suggests age-related disparities in palliative care delivery. This study aimed to assess the cumulative incidence function (CIF) of IPC delivery, as well as the influence of age.
The national ESME (Epidemio-Strategy-Medical-Economical)-MBC cohort includes consecutive MBC patients treated in 18 French Comprehensive Cancer Centres. ICD-10 palliative care coding was used for IPC identification.
Our analysis included 12,375 patients, 5093 (41.2%) of whom were aged 65 or over. The median follow-up was 41.5 months (95% confidence interval [CI], 40.5–42.5). The CIF of IPC was 10.3% (95% CI, 10.2–10.4) and 24.8% (95% CI, 24.7–24.8) at 2 and 8 years, respectively. At 2 years, among triple-negative patients, young patients (<65 yo) had a higher CIF of IPC than older patients after adjusting for cancer characteristics, centre and period (65+/<65: β = −0.05; 95% CI, −0.08 to −0.01). Among other tumour sub-types, older patients received short-term IPC more frequently than young patients (65+/<65: β = 0.02; 95% CI, 0.01 to 0.03). At 8 years, outside large centres, IPC was delivered less frequently to older patients adjusted to cancer characteristics and period (65+/<65: β = −0.03; 95% CI, −0.06 to −0.01).
We found a relatively low CIF of IPC and that age influenced IPC delivery. Young triple-negative and older non-triple-negative patients needed more short-term IPCs. Older patients diagnosed outside large centres received less long-term IPC. These findings highlight the need for a wider implementation of IPC facilities and for more age-specific interventions.
•Age was an independent factor of inpatient palliative care (IPC) delivery in metastatic breast cancer (MBC) patients.•This association depended on the tumour sub-type and the centre activity.•Young HER2-/HR- and older non-triple-negative patients needed more short-term IPC.•Older patients diagnosed in large centres more frequently received long-term IPC.•A wider implementation of IPC might improve access for older MBC patients.</description><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - rehabilitation</subject><subject>Cancer</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Female</subject><subject>History, 21st Century</subject><subject>Humans</subject><subject>Inpatient care</subject><subject>Life Sciences</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Metastatic breast cancer</subject><subject>Neoplasm Metastasis</subject><subject>Palliation</subject><subject>Palliative Care</subject><subject>Palliative medicine</subject><subject>Tumors</subject><issn>0959-8049</issn><issn>1879-0852</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-L1DAYh4so7rj6BTxIwIuCrW_Spm3EyziMrjCLgnoOafp2J6Vt1iSdZW5-BMFv6CcxZdY9ePCUl_D8fvnzJMlTChkFWr7uM-y1yhgwyKDKAKp7yYrWlUih5ux-sgLBRVpDIc6SR973EIm6gIfJWc5q4GVBV8nPz2oYjArmgEQrh6TFIc7uSJTW1rVmuiLBEnWFxEyEslexhNzYESdyY8KejBiUDzGvSeMwjrFl0ujekPWkhqM3fsmFPZJxHiKFU4iHbL9cbtPLdxui7d66QBhA_fvHLxZf9Th50KnB45Pb9Tz59n77dXOR7j59-LhZ71JdlCykiJ2iChF41emyaxoOimmqWd6wQne5LlvooOU1L1ld1yCqkpWNEHmTK0Y7zM-Tl6fevRrktTOjckdplZEX651c9oAJwTmlBxrZFyf22tnvM_ogR-M1DoOa0M5esiLnVFBR8Yg-_wft7eziVywUp5zzMmeRYidKO-u9w-7uBhTk4lb2cnErF7cSKhnNxdCz2-q5GbG9i_yVGYG3JwDjvx0MOum1wWijNQ51kK01_-v_A_vQsyM</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Frasca, Matthieu</creator><creator>Sabathe, Camille</creator><creator>Delaloge, Suzette</creator><creator>Galvin, Angeline</creator><creator>Patsouris, Anne</creator><creator>Levy, Christelle</creator><creator>Mouret-Reynier, Marie A.</creator><creator>Desmoulins, Isabelle</creator><creator>Vanlemmens, Laurence</creator><creator>Bachelot, Thomas</creator><creator>Goncalves, Anthony</creator><creator>Perotin, Virginie</creator><creator>Uwer, Lionel</creator><creator>Frenel, Jean S.</creator><creator>Ferrero, Jean M.</creator><creator>Bouleuc, Carole</creator><creator>Eymard, Jean C.</creator><creator>Dieras, Véronique</creator><creator>Leheurteur, Marianne</creator><creator>Petit, Thierry</creator><creator>Dalenc, Florence</creator><creator>Jaffre, Anne</creator><creator>Chevrot, Michaël</creator><creator>Courtinard, Coralie</creator><creator>Mathoulin-Pelissier, Simone</creator><general>Elsevier Ltd</general><general>Elsevier Science Ltd</general><general>Elsevier</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0003-0572-5222</orcidid><orcidid>https://orcid.org/0000-0002-0866-9484</orcidid><orcidid>https://orcid.org/0000-0001-9353-691X</orcidid><orcidid>https://orcid.org/0000-0001-7799-1648</orcidid><orcidid>https://orcid.org/0000-0001-7570-7439</orcidid><orcidid>https://orcid.org/0000-0002-8746-0725</orcidid><orcidid>https://orcid.org/0000-0001-5542-5813</orcidid><orcidid>https://orcid.org/0000-0001-6981-1678</orcidid><orcidid>https://orcid.org/0000-0003-2106-9165</orcidid></search><sort><creationdate>202009</creationdate><title>Palliative care delivery according to age in 12,000 women with metastatic breast cancer: Analysis in the multicentre ESME-MBC cohort 2008–2016</title><author>Frasca, Matthieu ; 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However, mounting evidence suggests age-related disparities in palliative care delivery. This study aimed to assess the cumulative incidence function (CIF) of IPC delivery, as well as the influence of age.
The national ESME (Epidemio-Strategy-Medical-Economical)-MBC cohort includes consecutive MBC patients treated in 18 French Comprehensive Cancer Centres. ICD-10 palliative care coding was used for IPC identification.
Our analysis included 12,375 patients, 5093 (41.2%) of whom were aged 65 or over. The median follow-up was 41.5 months (95% confidence interval [CI], 40.5–42.5). The CIF of IPC was 10.3% (95% CI, 10.2–10.4) and 24.8% (95% CI, 24.7–24.8) at 2 and 8 years, respectively. At 2 years, among triple-negative patients, young patients (<65 yo) had a higher CIF of IPC than older patients after adjusting for cancer characteristics, centre and period (65+/<65: β = −0.05; 95% CI, −0.08 to −0.01). Among other tumour sub-types, older patients received short-term IPC more frequently than young patients (65+/<65: β = 0.02; 95% CI, 0.01 to 0.03). At 8 years, outside large centres, IPC was delivered less frequently to older patients adjusted to cancer characteristics and period (65+/<65: β = −0.03; 95% CI, −0.06 to −0.01).
We found a relatively low CIF of IPC and that age influenced IPC delivery. Young triple-negative and older non-triple-negative patients needed more short-term IPCs. Older patients diagnosed outside large centres received less long-term IPC. These findings highlight the need for a wider implementation of IPC facilities and for more age-specific interventions.
•Age was an independent factor of inpatient palliative care (IPC) delivery in metastatic breast cancer (MBC) patients.•This association depended on the tumour sub-type and the centre activity.•Young HER2-/HR- and older non-triple-negative patients needed more short-term IPC.•Older patients diagnosed in large centres more frequently received long-term IPC.•A wider implementation of IPC might improve access for older MBC patients.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>32805641</pmid><doi>10.1016/j.ejca.2020.07.007</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-0572-5222</orcidid><orcidid>https://orcid.org/0000-0002-0866-9484</orcidid><orcidid>https://orcid.org/0000-0001-9353-691X</orcidid><orcidid>https://orcid.org/0000-0001-7799-1648</orcidid><orcidid>https://orcid.org/0000-0001-7570-7439</orcidid><orcidid>https://orcid.org/0000-0002-8746-0725</orcidid><orcidid>https://orcid.org/0000-0001-5542-5813</orcidid><orcidid>https://orcid.org/0000-0001-6981-1678</orcidid><orcidid>https://orcid.org/0000-0003-2106-9165</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0959-8049 |
| ispartof | European journal of cancer (1990), 2020-09, Vol.137, p.240-249 |
| issn | 0959-8049 1879-0852 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_02995511v1 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Age Age Factors Aged Breast cancer Breast Neoplasms - rehabilitation Cancer Cohort Studies Confidence intervals Female History, 21st Century Humans Inpatient care Life Sciences Metastases Metastasis Metastatic breast cancer Neoplasm Metastasis Palliation Palliative Care Palliative medicine Tumors |
| title | Palliative care delivery according to age in 12,000 women with metastatic breast cancer: Analysis in the multicentre ESME-MBC cohort 2008–2016 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T09%3A48%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Palliative%20care%20delivery%20according%20to%20age%20in%2012,000%20women%20with%20metastatic%20breast%20cancer:%20Analysis%20in%20the%20multicentre%20ESME-MBC%20cohort%202008%E2%80%932016&rft.jtitle=European%20journal%20of%20cancer%20(1990)&rft.au=Frasca,%20Matthieu&rft.date=2020-09&rft.volume=137&rft.spage=240&rft.epage=249&rft.pages=240-249&rft.issn=0959-8049&rft.eissn=1879-0852&rft_id=info:doi/10.1016/j.ejca.2020.07.007&rft_dat=%3Cproquest_hal_p%3E2451555632%3C/proquest_hal_p%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2451555632&rft_id=info:pmid/32805641&rft_els_id=S0959804920303907&rfr_iscdi=true |