Pre-screening of patient-reported symptoms using the Edmonton Symptom Assessment System in outpatient palliative cancer care
Menée en Corée à partir de données portant sur 71 patients atteints d’un cancer de stade avancé (âge médian : 65 ans), cette étude analyse le niveau de sévérité de leurs symptômes auto-déclarés et l’association avec leurs besoins en soins palliatifs
Objectives : Although early palliative care is associated with a better quality of life and improved outcomes in end?of?life cancer care, the criteria of palliative care referral are still elusive. Methods : We collected patient?reported symptoms using the Edmonton Symptom Assessment System (ESAS) at the baseline, first and second follow?up visits. A total of 71 patients were evaluable, with a median age of 65 years, male (62%) and Eastern Cooperative Oncology Group (ECOG) performance status distribution of 1/2/3 (28%/39%/33%) respectively. Results : Twenty (28%) patients had moderate/severe symptom burden with the mean ESAS ? 5. Interestingly, most of the patients with moderate/severe symptom burdens (ESAS ? 5) had globally elevated symptom expression. While the mean ESAS score was maintained in patients with mild symptom burden (ESAS < 5; 2.7 at the baseline; 3.4 at the first follow?up; 3.0 at the second follow?up; p = .117), there was significant symptom improvement in patients with moderate/severe symptom burden (ESAS ? 5; 6.5 at the baseline; 4.5 at the first follow?up; 3.6 at the second follow?up; p < .001). Conclusions : In conclusion, advanced cancer patients with ESAS ? 5 may benefit from outpatient palliative cancer care. Pre?screening of patient?reported symptoms using ESAS can be useful for identifying unmet palliative care needs in advanced cancer patients.