• Sebastiano Mercadante, Yasmine Grassi, CascioAlessio LoALMain regional center for Pain relief and palliative care Unit, La Maddalena Cancer Center (S.M., Y.G., A.L.C., V.R.), Palermo, Italy., Vincenzo Restivo, and Alessandra Casuccio.
• Main regional center for Pain relief and palliative care Unit, La Maddalena Cancer Center (S.M., Y.G., A.L.C., V.R.), Palermo, Italy. Electronic address: terapiadeldolore@lamaddalenanet.it.
• J Pain Symptom Manage. 2023 Jun 1; 65 (6): e677e682e677-e682.

BackgrundThe characteristics of patients who had never received anticancer treatments at admission of an acute supportive palliative care unit (ASPCU) have never been explored.MeasuresFrom a consecutive sample of 422 advanced cancer patients, 62 patients with no previous anticancer therapy were selected and compared with a random sample of patients who had received anticancer treatments. Age, gender, primary tumor, Karnofsky status, characteristics of admission, the level of education, economic status, awareness of disease, the presence of cachexia, and comorbidities and palliative prognostic score, symptom intensity, opioid drugs used at admission, reasons for admission to APSCU were recorded in both groups. At time of discharge, ESAS and analgesic drugs used were recorded again. Discharge modalities were also recorded. One month after the end of recruitment period (the last patient enrollment), a follow-up was performed by phone contacts with relatives to assess survival at three months after discharge.OutcomesPatients without previous anticancer therapy (14.7%) were mainly admitted to ASPCU for a low Karnofsky level and high symptom burden, often waiting for or needing a histological diagnosis to make a decision for the next therapeutic steps. This group of patients were older (P<0.0005), more frequently males (P=0.007), and had more comorbidities (P<0.0005) in comparison with treated patients. Twenty-four per cent of these patients started chemotherapy subsequently. Treatment-naive patients had a higher level of symptom burden, which was less responsive to a comprehensive palliative and more frequently died within three months in comparison with treated patients.DiscussionTreatment-naive patients showed a higher level of symptom burden, which was less responsive to a comprehensive palliative treatment. In addition they more frequently died within three months in comparison with treated patients.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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