[Skip to Content]
[Skip to Content Landing]
Views 518
Citations 0
Comment & Response
January 16, 2020

Association of Early Palliative Care With Survival in Patients With Advanced Lung Cancer

Author Affiliations
  • 1Department of Pharmacy, General Hospital Šibenik, Šibenik, Croatia
  • 2Department of Pharmacy, General Hospital Bjelovar, Bjelovar, Croatia
  • 3Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
JAMA Oncol. 2020;6(3):442-443. doi:10.1001/jamaoncol.2019.6295

To the Editor We have read with great interest the retrospective population-based cohort study by Sullivan et al.1 They found an association of early palliative care (received 0 to 30 days after cancer diagnosis) with decreased survival (adjusted hazard ratio, 2.13; 95% CI, 1.97-2.30) in patients with advanced lung cancer.

The authors used the propensity score method for reduction of selection bias among groups. The propensity score included factors such as the Charlson Comorbidity Index score and the Functional Comorbidity Index score. However, these parameters do not represent the true performance status of patients. Performance status is one of the major factors in cancer treatment decision-making and is assessed using the Eastern Cooperative Oncology Group scale2 or the Karnofsky scale.3 In addition, performance status is also associated with specialists’ decisions to deliver palliative care. Therefore, patients with greater functional impairment are more likely to receive palliative care sooner.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×