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British Journal of Oral and Maxillofacial Surgery 52 (2014) 458–460
Short communication
Place and time of death in patients treated with palliative intent for oral cancer A. Kamisetty a,∗ , C.R. Mayland b , B. Jack c , D. Lowe c , S.N. Rogers a,c a b c
Regional Maxillofacial Unit, University Hospital Aintree, Liverpool L9 1AE, United Kingdom Marie Curie Palliative Care, University of Liverpool, Liverpool L69 3BX, United Kingdom Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, St Helens Road, Ormskirk L39 4QP, United Kingdom
Accepted 6 March 2014 Available online 8 April 2014
Abstract Information about place and time of death can help patients, carers, general medical practitioners, and multi-professional teams to put palliation for oral cancer into context, particularly the aspirations of patients about where they die. Aintree Regional Maxillofacial Unit treated 487 consecutive patients for primary oral squamous cell carcinoma between 2006 and 2010. Mortality was ascertained from the Office for National Statistics. A total of 65 (13%) patients were treated with palliative intent, and median (IQR) survival was 4.3 months (2.1–8.0). The most common reasons for palliation were inoperability (33%) and extensive disease associated with serious comorbidity (18%). A total of 22 died in hospital, 14 in a hospice, 14 in their own home, 14 in a nursing, residential, or old people’s home, and one elsewhere. Most patients given palliative care do not die in hospital and survival is short. Their needs and those of their carers can be better met through integrated care that is linked to the primary sector. © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Keywords: Palliative care; Head and neck cancer; Oral cancer; Place of death
Introduction Relatively little has been published on patients treated with palliative intent for oral cancer.1 Around 20% of patients are treated palliatively,2 and quality of care and place of death are important. In general population studies, respondents state a preference to die at home, but rates vary for those with head and neck cancer. Ethunandan et al.,3 reported that 63% died
∗ Corresponding author at: Aintree University Hospital, Lower Lane, Liverpool L9 7AL, United Kingdom. Tel.: +44 0151 529 5287; fax: +44 0151 529 5288. E-mail addresses: [email protected] (A. Kamisetty), [email protected] (C.R. Mayland), [email protected] (B. Jack), [email protected] (D. Lowe), [email protected] (S.N. Rogers).
in hospital and 16% at home while Ledeboer et al.4 reported that 23% died in hospital and most died at home. We reviewed the case notes of patients with oral cancer who were treated with palliative intent in the Merseyside and Cheshire cancer network to ascertain the proportion of new patients treated palliatively, the reasons for this, the time to death, and place of death. This information can help patients, carers, general medical practitioners, and members of the multi-professional team to have a better understanding of the situation when they discuss palliative care and a patient’s preference about where they want to die.
Patients and methods We used the computerised head and neck database in the Aintree Regional Maxillofacial Unit to identify consecutive
http://dx.doi.org/10.1016/j.bjoms.2014.03.003 0266-4356/© 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
A. Kamisetty et al. / British Journal of Oral and Maxillofacial Surgery 52 (2014) 458–460 Table 1 Patients’ details and palliative treatment. No. of patients (n = 485) Sex Male Female Age (years)
British Journal of Oral and Maxillofacial Surgery 52 (2014) 458–460
Short communication
Place and time of death in patients treated with palliative intent for oral cancer A. Kamisetty a,∗ , C.R. Mayland b , B. Jack c , D. Lowe c , S.N. Rogers a,c a b c
Regional Maxillofacial Unit, University Hospital Aintree, Liverpool L9 1AE, United Kingdom Marie Curie Palliative Care, University of Liverpool, Liverpool L69 3BX, United Kingdom Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, St Helens Road, Ormskirk L39 4QP, United Kingdom
Accepted 6 March 2014 Available online 8 April 2014
Abstract Information about place and time of death can help patients, carers, general medical practitioners, and multi-professional teams to put palliation for oral cancer into context, particularly the aspirations of patients about where they die. Aintree Regional Maxillofacial Unit treated 487 consecutive patients for primary oral squamous cell carcinoma between 2006 and 2010. Mortality was ascertained from the Office for National Statistics. A total of 65 (13%) patients were treated with palliative intent, and median (IQR) survival was 4.3 months (2.1–8.0). The most common reasons for palliation were inoperability (33%) and extensive disease associated with serious comorbidity (18%). A total of 22 died in hospital, 14 in a hospice, 14 in their own home, 14 in a nursing, residential, or old people’s home, and one elsewhere. Most patients given palliative care do not die in hospital and survival is short. Their needs and those of their carers can be better met through integrated care that is linked to the primary sector. © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Keywords: Palliative care; Head and neck cancer; Oral cancer; Place of death
Introduction Relatively little has been published on patients treated with palliative intent for oral cancer.1 Around 20% of patients are treated palliatively,2 and quality of care and place of death are important. In general population studies, respondents state a preference to die at home, but rates vary for those with head and neck cancer. Ethunandan et al.,3 reported that 63% died
∗ Corresponding author at: Aintree University Hospital, Lower Lane, Liverpool L9 7AL, United Kingdom. Tel.: +44 0151 529 5287; fax: +44 0151 529 5288. E-mail addresses: [email protected] (A. Kamisetty), [email protected] (C.R. Mayland), [email protected] (B. Jack), [email protected] (D. Lowe), [email protected] (S.N. Rogers).
in hospital and 16% at home while Ledeboer et al.4 reported that 23% died in hospital and most died at home. We reviewed the case notes of patients with oral cancer who were treated with palliative intent in the Merseyside and Cheshire cancer network to ascertain the proportion of new patients treated palliatively, the reasons for this, the time to death, and place of death. This information can help patients, carers, general medical practitioners, and members of the multi-professional team to have a better understanding of the situation when they discuss palliative care and a patient’s preference about where they want to die.
Patients and methods We used the computerised head and neck database in the Aintree Regional Maxillofacial Unit to identify consecutive
http://dx.doi.org/10.1016/j.bjoms.2014.03.003 0266-4356/© 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
A. Kamisetty et al. / British Journal of Oral and Maxillofacial Surgery 52 (2014) 458–460 Table 1 Patients’ details and palliative treatment. No. of patients (n = 485) Sex Male Female Age (years)
