Role of palliative care intervention in patients with vulvar cancer: a retrospective study.

IF 2 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES BMJ Supportive & Palliative Care Pub Date : 2024-12-19 DOI:10.1136/spcare-2023-004734
Silvia Rosa Allende, Rosa Salcedo-Hernandez, Georgina Dominguez Ocadio, Adriana Peña-Nieves, David Isla-Ortiz, Emma L Verástegui, Paula Cabrera-Galeana
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Abstract

Objective: To describe the experience of a Mexican cancer centre in vulvar cancer and the opportunity to incorporate palliative care (PC) during treatment.

Patients and methods: A retrospective study of clinical and sociodemographic characteristics of women with vulvar cancer referred to the PC service (PCS) between 2010 and 2021 is reported. Frequencies were estimated, as well as medians and IQRs, accordingly. Referral time and overall survival were estimated using the Kaplan-Meier method.

Results: 125 women with vulvar cancer were seen between 2010 and 2021, but only 42% were seen at PCS, mostly polysymptomatic, after several visits to the emergency room. 89% of the patients seen at PCS died at home.

Conclusions: Vulvar cancer is a rare type of cancer, while squamous cell carcinoma is the most frequent type. At the time of referral, almost half of the patients had severe pain, bleeding, malodor, infection and urinary incontinence. Most of these patients lived in poverty, were poorly educated and had multiple surgeries. PC may play an important role in the care of patients with advanced vulvar cancer, relieving the physical and psychological symptoms, avoiding unnecessary hospitalisation and favouring death at home without pain and other symptoms.

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姑息治疗干预在外阴癌患者中的作用:一项回顾性研究。
摘要描述墨西哥一家癌症中心在外阴癌方面的经验,以及在治疗过程中纳入姑息治疗(PC)的机会:患者和方法:本报告对2010年至2021年期间转诊至姑息治疗服务(PCS)的外阴癌女性患者的临床和社会人口特征进行了回顾性研究。据此估算了频率、中位数和IQR。采用 Kaplan-Meier 法估算了转诊时间和总生存率:2010年至2021年间,125名女性外阴癌患者在PCS就诊,但只有42%的患者在多次急诊就诊后在PCS就诊,其中大部分患者为多症状患者。89%在PCS就诊的患者死于家中:结论:外阴癌是一种罕见的癌症,而鳞状细胞癌是最常见的癌症类型。转诊时,近一半的患者有剧烈疼痛、出血、恶臭、感染和尿失禁等症状。这些患者大多生活贫困,受教育程度低,并接受过多次手术。PC可在晚期外阴癌患者的护理中发挥重要作用,缓解患者的生理和心理症状,避免不必要的住院治疗,有利于患者在没有疼痛和其他症状的情况下在家中去世。
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来源期刊
BMJ Supportive & Palliative Care
BMJ Supportive & Palliative Care Medicine-Medicine (miscellaneous)
CiteScore
4.60
自引率
7.40%
发文量
170
期刊介绍: Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance. We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication. In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.
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