Real-World Insights: End-of-Life Care for Patients with Terminal Gastric Cancer at Home.

Background: As the Japanese population continues to age, home health care provision has greater significance. However, the number of patients with terminal cancer receiving end-of-life care at home remains limited, and predicting the prognosis of patients with terminal-stage gastric cancer is challenging.

Objective: To analyze the real-world data of patients with terminal gastric cancer receiving end-of-life care at home to provide insights into their care and health outcomes.

Design: A two-center retrospective study.

Setting/subjects: This study focused on terminal patients with gastric cancer who died at home between 2021 and 2024 in Japan. A total of 27 participants (14 males and 13 females) were included in the study, with a median age of 78 years.

Measurements: First, we analyzed the detailed clinical course of the patients during home care. Second, we performed a comparative analysis by dividing the patients into two groups based on median overall survival (OS).

Results: The median OS during home care was 22 days. The patients were divided into two groups: long OS (OS-L) and short OS (OS-S). Strong opioid use and home oxygen therapy were recorded in 22 and nine patients, respectively. In the OS-S group, oral intake was significantly reduced (25.0% vs. 66.7%, p = 0.032). There was a notable difference in serum albumin levels between the two groups (2.8 vs. 2.4 mg/dL, p = 0.038). The neutrophil-to-lymphocyte ratio (NLR)/albumin was significantly higher in the OS-S group compared to the OS-L group (1.0 vs. 2.3, p = 0.032).

Conclusions: Oral intake, serum albumin level, and NLR/albumin were important prognostic factors in end-of-life care at home of patients with terminal gastric cancer.