Cancer Research and Treatment

Original Articles

General

Analysis of Cancer Patient Decision-Making and Health Service Utilization after Enforcement of the Life-Sustaining Treatment Decision-Making Act in Korea: Dalyong Kim, Shin Hye Yoo, Seyoung Seo, Hyun Jung Lee, Min Sun Kim, Sung Joon Shin, Chi-Yeon Lim, Do Yeun Kim, Dae Seog Heo, Chae-Man Lim; Cancer Res Treat. 2022;54(1):20-29. Published online April 12, 2021; DOI: https://doi.org/10.4143/crt.2021.131

Purpose
This study aimed to confirm the decision-making patterns for life-sustaining treatment (LST) and analyze medical service utilization changes after enforcement of the Life-Sustaining Treatment Decision-Making Act.
Materials and Methods
Of 1,237 patients who completed legal forms for life-sustaining treatment (hereafter called the LST form) at three academic hospitals and died at the same institutions, 1,018 cancer patients were included. Medical service utilization and costs were analyzed using claims data.
Results
The median time to death from completion of the LST form was three days (range, 0 to 248 days). Of these, 517 people died within two days of completing the document, and 36.1% of all patients prepared the LST form themselves. The frequency of use of the intensive care unit, continuous renal replacement therapy, and mechanical ventilation was significantly higher when the families filled out the form without knowing the patient’s intention. In the top 10% of the medical expense groups, the decision-makers for LST were family members rather than patients (28% patients vs. 32% family members who knew and 40% family members who did not know the patient’s intention).
Conclusion
The cancer patient’s own decision-making rather than the family’s decision was associated with earlier decision-making, less use of some critical treatments (except chemotherapy) and expensive evaluations, and a trend toward lower medical costs.

Citations

Citations to this article as recorded by

Factors Affecting Life-Sustaining Treatment Decisions and Changes in Clinical Practice after Enforcement of the Life-Sustaining Treatment (LST) Decision Act: A Tertiary Hospital Experience in Korea
Yoon Jung Jang, Yun Jung Yang, Hoi Jung Koo, Hye Won Yoon, Seongbeom Uhm, Sun Young Kim, Jeong Eun Kim, Jin Won Huh, Tae Won Kim, Seyoung Seo
Cancer Research and Treatment.2025; 57(1): 280. CrossRef
Characteristics of Life-Sustaining Treatment Decisions: National Data Analysis in South Korea
Jiyeon Choi, Heejung Jeon, Ilhak Lee
Asian Bioethics Review.2024; 16(1): 33. CrossRef
Characteristics and outcomes of patients with do-not-resuscitate and physician orders for life-sustaining treatment in a medical intensive care unit: a retrospective cohort study
Song-I Lee, Ye-Rin Ju, Da Hyun Kang, Jeong Eun Lee
BMC Palliative Care.2024;[Epub] CrossRef
For the Universal Right to Access Quality End-of-Life Care in Korea: Broadening Our Perspective After the 2018 Life-Sustaining Treatment Decisions Act
Hye Yoon Park, Min Sun Kim, Shin Hye Yoo, Jung Lee, In Gyu Song, So Yeon Jeon, Eun Kyung Choi
Journal of Korean Medical Science.2024;[Epub] CrossRef
Comparison of factors influencing the decision to withdraw life-sustaining treatment in intensive care unit patients after implementation of the Life-Sustaining Treatment Act in Korea
Claire Junga Kim, Kyung Sook Hong, Sooyoung Cho, Jin Park
Acute and Critical Care.2024; 39(2): 294. CrossRef
Nurses' engagement in advance care planning practices: A descriptive cross‐sectional study
Sangmin Lee, Naixue Cui, Hyejin Kim
Journal of Clinical Nursing.2024;[Epub] CrossRef
Issues and implications of the life-sustaining treatment decision act: comparing the data from the survey and clinical data of inpatients at the end-of-life process
Eunjeong Song, Dongsoon Shin, Jooseon Lee, Seonyoung Yun, Minjeong Eom, Suhee Oh, Heejung Lee, Jiwan Lee, Rhayun Song
BMC Medical Ethics.2024;[Epub] CrossRef
Development and Feasibility Evaluation of Smart Cancer Care 2.0 Based on Patient-Reported Outcomes for Post-Discharge Management of Patients with Cancer
Jin Ah Kwon, Songsoo Yang, Su-Jin Koh, Young Ju Noh, Dong Yoon Kang, Sol Bin Yang, Eun Ji Kwon, Jeong-Wook Seo, Jin sung Kim, Minsu Ock
Cancer Research and Treatment.2024; 56(4): 1040. CrossRef
Advance Care Planning in South Korea
Yu Jung Kim, Sun-Hyun Kim
Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen.2023; 180: 68. CrossRef
Preferred versus Actual Place of Care and Factors Associated with Home Discharge among Korean Patients with Advanced Cancer: A Retrospective Cohort Study
In Young Hwang, Yohan Han, Min Sun Kim, Kyae Hyung Kim, Belong Cho, Wonho Choi, Yejin Kim, Shin Hye Yoo, Sun Young Lee
Healthcare.2023; 11(13): 1939. CrossRef

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Palliative Medicine

Safety, Efficacy, and Patient Satisfaction with Initial Peripherally Inserted Central Catheters Compared with Usual Intravenous Access in Terminally Ill Cancer Patients: A Randomized Phase II Study: Eun Ju Park, Kwonoh Park, Jae-Joon Kim, Sang-Bo Oh, Ki Sun Jung, So Yeon Oh, Yun Jeong Hong, Jin Hyeok Kim, Joo Yeon Jang, Ung-Bae Jeon; Cancer Res Treat. 2021;53(3):881-888. Published online December 22, 2020; DOI: https://doi.org/10.4143/crt.2020.1008

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to investigate whether routine insertion of peripherally inserted central catheter (PICC) at admission to a hospice-palliative care (HPC) unit is acceptable in terms of safety and efficacy and whether it results in superior patient satisfaction compared to usual intravenous (IV) access.
Materials and Methods
Terminally ill cancer patients were randomly assigned to two arms: routine PICC access and usual IV access arm. The primary endpoint was IV maintenance success rate, defined as the rate of functional IV maintenance until the intended time (discharge, transfer, or death).
Results
A total of 66 terminally ill cancer patients were enrolled and randomized to study arms. Among them, 57 patients (routine PICC, 29; usual IV, 28) were analyzed. In the routine PICC arm, mean time to PICC was 0.84 days (range, 0 to 3 days), 27 patients maintained PICC with function until the intended time. In the usual IV arm, 11 patients maintained peripheral IV access until the intended time, and 15 patients underwent PICC insertion. The IV maintenance success rate in the routine PICC arm (27/29, 93.1%) was similar to that in the usual IV arm (26/28, 92.8%, p=0.958). Patient satisfaction at day 5 was better in the routine PICC arm (97%, ‘a little comfort’ or ‘much comfort’) compared with the usual IV arm (21%) (p <0.001).
Conclusion
Routine PICC insertion in terminally ill cancer patients was comparable in safety and efficacy and resulted in superior satisfaction compared with usual IV access. Thus, routine PICC insertion could be considered at admission to the HPC unit.

Citations

Citations to this article as recorded by

A Phase II Study About Efficacy and Safety of the Continuous IntraVenous Infusion of Ketamine as Adjuvant to Opioids in Terminally Ill Cancer Patients With Refractory Cancer Pain (CIVIK Trial)
Kwonoh Park, Jae-Joon Kim, Sang-Bo Oh, So Yeon Oh, Yun Jeong Hong, Seo-jun Kim, Eun-Ju Park, Nayeon Choi, Seon-Hi Shin, Sungeun Kim, Heejung Ko
American Journal of Hospice and Palliative Medicine®.2025; 42(3): 244. CrossRef
Implementation of Tunneled Peripherally Inserted Central Catheters Placement in Cancer Patients: A Randomized Multicenter Study
Yuan Sheng, Li-Hong Yang, Yan Wu, Wei Gao, Sheng-Yi Dongye
Clinical Nursing Research.2024; 33(1): 19. CrossRef
The Use of a High Flow PICC Catheter for Stem Cell and Lymphocyte Apheresis: The Initial Experience of a Pediatric Oncology Center in Brazil
Vilani Kremer, Andréia Rheinheimer, Ana Luiza Rodrigues, Andressa Taborda, Robson Coelho, Antonella Zanette
Journal of Pediatric Surgery.2024; 59(8): 1600. CrossRef
Analysis of Risk Factors for Peripherally Inserted Central Venous Catheter-Associated Bloodstream Infection
Sungho Lee, Kwanhoon Park, Kang Yoon Lee, Dongbeen Choi, Ji Young Jang
Journal of Acute Care Surgery.2024; 14(1): 9. CrossRef
Central venous access device terminologies, complications, and reason for removal in oncology: a scoping review
Kerrie Curtis, Karla Gough, Meinir Krishnasamy, Elena Tarasenko, Geoff Hill, Samantha Keogh
BMC Cancer.2024;[Epub] CrossRef
Use of peripherally inserted central venous catheters and midline catheters for palliative care in patients with cancer: a systematic review
Eva Gravdahl, Dagny Faksvåg Haugen, Olav Magnus Fredheim
Supportive Care in Cancer.2024;[Epub] CrossRef
Machine Learning Predicts Peripherally Inserted Central Catheters-Related Deep Vein Thrombosis Using Patient Features and Catheterization Technology Features
Yuan Sheng, Wei Gao
Clinical Nursing Research.2024; 33(6): 460. CrossRef
Safety of Cryopreserved Stem Cell Infusion through a Peripherally Inserted Central Venous Catheter
Sławomir Milczarek, Piotr Kulig, Alina Zuchmańska, Bartłomiej Baumert, Bogumiła Osękowska, Anna Bielikowicz, Ewa Wilk-Milczarek, Bogusław Machaliński
Cancers.2023; 15(4): 1338. CrossRef
Use and safety of peripherally inserted central catheters and midline catheters in palliative care cancer patients: a retrospective review
Eva Gravdahl, Siri Steine, Knut Magne Augestad, Olav Magnus Fredheim
Supportive Care in Cancer.2023;[Epub] CrossRef
Complications of Central Venous Access Devices Used in Palliative Care Settings for Terminally Ill Cancer Patients: A Systematic Review and Meta-Analysis
Clement Chun-Him Wong, Horace Cheuk-Wai Choi, Victor Ho-Fun Lee
Cancers.2023; 15(19): 4712. CrossRef
Safety and Efficacy of Peripherally Inserted Central Catheter Placement by Surgical Intensivist–Led Vascular Access Team
Byunghyuk Yu, Jihoon Hong
Vascular Specialist International.2022;[Epub] CrossRef
Effects of parenteral nutrition and hydration on survival in advanced cancer patients with malignant bowel obstruction: secondary analysis of a multicenter prospective cohort study
Sayaka Arakawa, Koji Amano, Shunsuke Oyamada, Isseki Maeda, Hiroto Ishiki, Tomofumi Miura, Yutaka Hatano, Akemi Shirado Naito, Mamiko Sato, Tetsuya Ito, Kazuhiro Kosugi, Satoshi Miyake, Tatsuya Morita, Masanori Mori, Satoshi Inoue, Naosuke Yokomichi, Keng
Supportive Care in Cancer.2021; 29(12): 7541. CrossRef
Catheter-related bloodstream infection associated with multiple insertions of the peripherally inserted central catheter in patients with hematological disorders
Yoshinori Hashimoto, Rina Hosoda, Hiromi Omura, Takayuki Tanaka
Scientific Reports.2021;[Epub] CrossRef

6,973 View
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