Highlights
- •Palliative interventions for Stage IV renal cell carcinoma (RCC) are poorly understood.
- •Palliative intervention use has minimally increased for metastatic RCC.
- •Several factors affect palliative intervention use for metastatic RCC.
- •Treatment-specific factors influence palliative intervention use for metastatic RCC
Abstract
Introduction
Several guidelines have adopted early integration of palliative intervention (PI)
into oncologic care to improve quality of life among patients with advanced malignancies.
However, PI utilization patterns and factors associated with its use in metastatic
renal cell carcinoma are poorly understood.
Patients and Methods
Using the National Cancer Database (NCDB), we abstracted patients diagnosed with Stage
IV RCC from 2004 to 2014 and evaluated the utilization of PI within this cohort. Socioeconomic
and clinical factors were compared for patients receiving and not receiving PI for
metastatic RCC. Multivariable logistic regression (MLR) models identified factors
that were associated with receipt of PI within overall cohort and treatment-based
cohorts.
Results
We identified 42,014 patients with Stage IV RCC, of which 7,912 patients received
PI. From 2004 to 2014, the use of PI minimally increased from 17% to 20% for Stage
IV RCC. MLR analysis demonstrated that increased comorbidities, insurance status,
higher education status, facility location, care at a comprehensive cancer program
or integrated network, sarcomatoid histology, and treatment type significantly increased
the likelihood of PI use. Various socioeconomic, clinical, and geographical factors
that are associated with use of PI-based on the treatment received for Stage IV RCC.
Conclusions
While PI utilization has minimally increased for Stage IV RCC, there are several geographic,
socioeconomic, and clinical factors that predict its use among patients with Stage
IV RCC in a treatment-specific manner. Taken together, this suggests the need for
earlier initiation of PI in a more equitable and systematic fashion among patients
with metastatic RCC.
Key Words
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Article Info
Publication History
Published online: January 06, 2022
Accepted:
January 2,
2022
Received in revised form:
December 19,
2021
Received:
September 10,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
