Hiratsuka Yusuke, Suh Sang-Yeon, Won Seon-Hye, Kim Sun-Hyun, Yoon Seok-Joon, Koh Su-Jin, Kwon Jung Hye, Park Jeanno, Ahn Hong-Yup, Cheng Shao-Yi, Chen Ping-Jen, Yamaguchi Takashi, Morita Tatsuya, Tsuneto Satoru, Mori Masanori, Inoue Akira
Department of Palliative Medicine, Takeda General Hospital, Aizuwakamatsu, Japan.
Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan.
Support Care Cancer. 2022 Jun;30(6):5499-5508. doi: 10.1007/s00520-022-06969-9. Epub 2022 Mar 19.
Few large-scale studies have focused on the prevalence of symptoms and signs during the last days of patients diagnosed with advanced cancer. Identifying the patterns of specific symptoms according to cancer type is helpful to provide end-of-life care for patients with advanced cancer. We investigated the prevalence and severity of symptoms and signs associated with impending death in patients with advanced cancer.
In this secondary analysis of an international multicenter cohort study conducted in three East Asian countries, we compared the severity of symptoms and signs among dying patients in the last 3 days of life according to the type of primary cancer using one-way analysis of variance (ANOVA). Post hoc analysis was conducted for multiple comparisons of each symptom according to the type of primary cancer.
We analyzed 2131 patients from Japan, Korea, and Taiwan. The prevalence of most symptoms and signs were relatively stable from 1 week after admission to the last 3 days of life. According to cancer type, edema of the lower extremities was the most common symptom and fatigue/ ascites were the most severe symptoms in digestive tract cancer. For lung cancer, respiratory secretion was the most prevalent and dyspnea/respiratory secretion were the most severe symptoms.
We demonstrated the prevalence and severity of symptoms and signs associated with the impending death of patients with advanced cancer in East Asia. Our study can enable clinicians to recognize the specific symptoms and signs at the very end of life.
很少有大规模研究关注晚期癌症患者临终前症状和体征的发生率。根据癌症类型确定特定症状的模式有助于为晚期癌症患者提供临终关怀。我们调查了晚期癌症患者临终相关症状和体征的发生率及严重程度。
在这项对在三个东亚国家开展的国际多中心队列研究的二次分析中，我们使用单因素方差分析（ANOVA），根据原发性癌症类型比较了临终患者生命最后3天症状和体征的严重程度。针对每种症状，根据原发性癌症类型进行了事后多重比较分析。
我们分析了来自日本、韩国和台湾的2131例患者。大多数症状和体征的发生率从入院后1周直至生命的最后3天相对稳定。根据癌症类型，下肢水肿是消化道癌症最常见的症状，疲劳/腹水是最严重的症状。对于肺癌，呼吸道分泌物是最普遍的症状，呼吸困难/呼吸道分泌物是最严重的症状。
我们展示了东亚晚期癌症患者临终相关症状和体征的发生率及严重程度。我们的研究可使临床医生识别生命末期的特定症状和体征。
