eP288 - Palliative Care Consults for Stage IV Colorectal Cancer Patients with Liver Metastases Operated upon with Curative Intent: Does It Happen?

Purpose/Background: While overall survival has improved among patients receiving curative intent resection for stage IV colorectal cancer (CRC) with synchronous liver metastases (SLM), prognosis remains poor. Palliative care aims to help treat suffering and promote quality of life for terminally ill patients while continuing treatment. However, confusion with hospice care can lead to stigmatization of palliative involvement. Studies show surgical patients seldom receive palliative care compared to medical patients. The objective of this study is to determine the incidence and motivating factors to receiving palliative care among stage IV CRC patients who undergo curative resection.Methods/Interventions: Retrospective review was performed for all primary CRC patients with SLM who underwent curative intent resection from 2010 to 2020 within a large, closed healthcare organization. Patients with evidence of other metastases or those who did not receive curative intent primary CRC and SLM resection were excluded. Patients were then divided into those who received palliative consultation and those who did not. Univariate analysis including Pearson’s chi-squared and Students t-test was performed to compare demographics, outcomes, and complications between groups.Results/Outcomes: Of 113 patients meeting criteria, 48 (42.5%) received palliative consult and 65 (57.5%) did not. Demographic data was comparable between the two groups, including sex, race, medical center, median age of diagnosis, and insurance type. Both groups had similar rates of major liver resection (lobectomy or tri-segmentectomy). There was no significant difference in rates of radiation therapy, chemotherapy, immunotherapy, or median length of hospital stay. Those with postoperative complications were more likely to get a palliative consult (62.5% vs. 36.9%, p=0.007). Those with cancer recurrence were more likely to have a palliative consult (91.7% vs. 53.9%, p < 0.001). Those with palliative consult were more likely to be deceased at time of analysis (85.4% vs. 27.7%, p < 0.001). Median overall survival following last curative surgery was comparable between groups.Conclusion/

Discussion: Our data show that there is no demographic or treatment difference between those who did and did not receive palliative consult. Patients who had post-operative complications and cancer recurrence were more likely to get a palliative care consult. Those with palliative care consult were also more likely to be deceased at time of study. Ideally, palliative care is used throughout a patient’s serious illness course to be most effective. However, based on our findings it appears for surgical stage IV patients, utilization of palliative care is centered towards those with disease recurrence and serious complications in their final days. Further study is needed to determine barriers to palliative care consult.Results Table