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Clinical presentation and patterns of care for short-term survivors of malignant glioma

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Abstract

Palliative care provision for patients with high-grade malignant glioma is often under-utilised. Difficulties in prognostication and inter-patient variability in survival may limit timely referral. This study sought to (1) describe the clinical presentation of short-term survivors of malignant glioma (survival time <120 days); (2) map their hospital utilisation, including palliative and supportive care service use, and place of death; (3) identify factors which may be important to serve as a prompt for palliative care referral. A retrospective cohort study of incident malignant glioma cases between 2003–2009 surviving <120 days in Victoria, Australia was undertaken (n = 482). Cases were stratified according to the patient’s survival status (dead vs. alive) at the end of the diagnosis admission, and at 120 days from diagnosis. Palliative care was received by 78 % of patients who died during the diagnosis admission. Only 12 % of patients who survived the admission and then deteriorated rapidly dying in the following 120 days were referred to palliative care in their hospital admission, suggesting an important clinical subgroup that may miss out on being linked into palliative care services. The strongest predictor of death during the diagnosis admission was the presence of cognitive or behavioural symptoms, which may be an important prompt for early palliative care referral.

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Acknowledgments

This study was supported by translational cancer research Grant [EO109_29] from the Victorian Cancer Agency of the Victorian State Government Department of Health. The authors would like to acknowledge the time and expertise of the study advisory group who ensured the methodology, results, and interpretation of findings were clinically grounded: Ros Aylot, Amanda Bolleter, Dr Dianne Clifton, Dr Jeremy Couper, Dr Michael Dally, Prof Mark Rosenthal, Dr Peter Sherwen, and Jane Staker.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Centre for Palliative Care, St Vincent’s Hospital Melbourne, PO Box 2900, Fitzroy, VIC, 3065, Australia

    Anna Collins & Jennifer Philip

  2. Department of Medicine, Southern Clinical School, Monash University, Clayton, VIC, Australia

    Vijaya Sundararajan

  3. Department of Medicine, St. Vincent’s Hospital & the University of Melbourne, Fitzroy, VIC, Australia

    Vijaya Sundararajan

  4. Centre for Research Excellence in Patient Safety, Monash University, Melbourne, VIC, Australia

    Caroline A. Brand

  5. Melbourne EpiCentre, University of Melbourne and Melbourne Health, Parkville, VIC, Australia

    Caroline A. Brand & Megan A. Bohensky

  6. Department of Psychiatry, St Vincent’s Hospital Melbourne, Fitzroy, VIC, Australia

    Gaye Moore

  7. Social Work Department, St Vincent’s Hospital Melbourne, Fitzroy, VIC, Australia

    Carrie Lethborg

  8. Palliative Care Service, Alfred Health, Melbourne, VIC, Australia

    Michelle Gold

  9. Department of Neurosurgery, St Vincent’s Hospital Melbourne, Fitzroy, VIC, Australia

    Michael A. Murphy

Authors
  1. Anna Collins
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  2. Vijaya Sundararajan
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  3. Caroline A. Brand
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  4. Gaye Moore
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  6. Michelle Gold
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  7. Michael A. Murphy
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  8. Megan A. Bohensky
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  9. Jennifer Philip
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Correspondence to Anna Collins.

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Collins, A., Sundararajan, V., Brand, C.A. et al. Clinical presentation and patterns of care for short-term survivors of malignant glioma. J Neurooncol 119, 333–341 (2014). https://doi.org/10.1007/s11060-014-1483-5

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  • DOI: https://doi.org/10.1007/s11060-014-1483-5

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