Chemotherapy and Palliative Care at the End of Life in Patients With Ovarian and Endometrial Cancer: A Retrospective Study

BackgroundGynecological cancers are among the leading causes of cancer-related deaths, which makes it important to focus on the end-of-life (EOL) quality and its improvement among gynecological cancer patients. Several indirect indicators have been developed to assess poor EOL quality among gynecological cancer patients, and these indicators can be used to assess EOL quality across different settings.Objectives(1) To assess the EOL quality and its improvement; and (2) to assess the EOL care and its changes among gynecological cancer patients at Oulu University Hospital by quality care measures.DesignWe conducted a retrospective study, comparing 2 cohorts. Patient data were obtained from the records of Oulu University Hospital.Setting/SubjectsWe compared 2 cohorts of gynecological cancer patients who died between 1.1.2018 and 30.6.2020 (Cohort 1) and between 1.1.2021 and 30.6.2023 (Cohort 2).ResultsIn the latter cohort (Cohort 2), more patients were referred to palliative care (81% vs 94%, respectively). Additionally, there was a significant decrease in the proportion of patients receiving chemotherapy during the last 3 months of life in Cohort 2 (44% vs 25%). The time between the EOL discussion and death was longer in Cohort 2 (median 57 vs 125 days, respectively).ConclusionBased on these indicators, the EOL quality of patients with gynecological cancer at Oulu University Hospital may have improved in recent years. However, there remains room for improvement, particularly in the earlier initiation of palliative care.