Hospitalizations in older adults with advanced cancer: The role of chemotherapy Journal Article


Authors: O'Neill, C. B.; Atoria, C. L.; O'Reilly, E. M.; Henman, M. C.; Bach, P. B.; Elkin, E. B.
Article Title: Hospitalizations in older adults with advanced cancer: The role of chemotherapy
Abstract: Purpose In older patients with metastatic cancer, hospitalization for treatment toxicity may reduce the quality of an already limited life expectancy. We evaluated the association between chemotherapy for metastatic cancer and risk of hospitalization. Methods In the population-based SEER-Medicare dataset, we identified patients 66 years or older diagnosed with metastatic cancer of the bladder, breast, prostate, colon or rectum, esophagus, pancreas, stomach, ovaries, or lung in 2001 to 2009 who died by December 31, 2010. Chemotherapy recipients were matched to nonrecipients by age, sex, race, geographic region, comorbidity, and survival duration. We identified hospitalizations for any cause and for likely chemotherapy-related toxicity, comparing chemotherapy recipients with their matched peers. Results Of 18,486 patients who received chemotherapy for metastatic cancer, 92% were hospitalized at least once for any reason, including 51% hospitalized for a likely toxicity. The corresponding rates among matched nonrecipients were 83% and 34%. Chemotherapy was associated with a significantly increased risk of likely toxicity-related hospitalization in nearly all cancers, controlling for sociodemographic characteristics and other treatment. The association was greatest in patients with metastatic esophageal cancer (adjusted hazard ratio, 2.00; 95% CI, 1.11 to 3.60) and smallest in patients with metastatic prostate cancer (adjusted hazard ratio, 1.22; 95% CI, 1.01 to 1.47). Conclusion Hospitalizations are common in patients with incurable advanced malignancies and more likely among those who receive chemotherapy. Understanding common reasons for these events may help reduce adverse effects of chemotherapy for metastatic cancer and help patients and their families make informed treatment decisions. © 2016 by American Society of Clinical Oncology.
Journal Title: Journal of Oncology Practice
Volume: 12
Issue: 2
ISSN: 1554-7477
Publisher: American Society of Clinical Oncology  
Date Published: 2016-02-01
Start Page: 151-152, e138
End Page: e148
Language: English
DOI: 10.1200/jop.2015.004812
PROVIDER: scopus
PUBMED: 26869655
PMCID: PMC5702789
DOI/URL:
Notes: Article -- Export Date: 3 March 2016 -- Source: Scopus
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  1. Elena B Elkin
    163 Elkin
  2. Peter Bach
    255 Bach
  3. Eileen O'Reilly
    780 O'Reilly
  4. Coral Lynn Atoria
    51 Atoria