Evolution in Documented Goals of Care at End of Life for Adolescents and Younger Adults With Cancer
Menée aux Etats-Unis à partir de données de registres médicaux portant sur 1 929 adolescents ou jeunes adultes atteints d'un cancer de stade IV ou d'un cancer de stade I-III récidivant ou métastatique (âge : de 12 à 39 ans), cette étude examine les discussions documentées concernant les objectifs de soins (palliatifs, non palliatifs, non décidés, non discutés) dans les 90 derniers jours de vie
Résumé en anglais
Importance : Little is known about the nature of change in goals of care (GOC) over time among adolescents and younger adult (AYA) patients aged 12 to 39 years with cancer near the end of life. Understanding how GOC evolve may guide clinicians in supporting AYA patients in making end-of-life decisions.
Objective : To assess frequency, timing, and evolution of documented GOC among AYA patients with cancer in the last 90 days of life.
Design, Setting, and Participants : This cross-sectional study included a retrospective review of medical records from the Dana-Farber Cancer Institute, Kaiser Permanente Northern California, and Kaiser Permanente Southern California of AYA patients with cancer who were 12 to 39 years of age at death and who died between January 1, 2003, and December 31, 2019. Data were analyzed from July 1, 2023, through April 30, 2024.
Exposures : Stage IV cancer or stage I-III cancer with new metastasis or recurrence.
Main Outcome and Measures : The primary outcome was documented GOC discussions, categorized by timing before death as initial (>60 days), middle (31-60 days), or late (
