Benefits of Early Collaboration Between Oncologists and Palliative Care Physicians in Cases of Unplanned Hospitalization for Patients With Metastatic Cancer

Benefits of Early Collaboration Between Oncologists and Palliative Care Physicians in Cases of Unplanned Hospitalization for Patients With Metastatic Cancer

This is a multicenter, national, interventional, cluster-randomized study, "stepped wedge" design. This study includes patients with metastatic or locally advanced digestive, gynecological, ENT, or sarcoma cancer, currently undergoing systemic palliative treatment and hospitalized on an unscheduled basis. The study will aim to evaluate the impact of early palliative care implementation for patients with metastatic or advanced cancer identified during an unplanned hospitalization.

This study will aim to evaluate the effectiveness of early palliative care for patients with metastatic or advanced cancer identified through unscheduled hospitalization in terms of reducing "aggressive" treatment.

Other objectives of the study include :

Compare approaches in terms of overall survival, treatment toxicities, advance directives, quality of life, anxiety, and depression.

• Describing care according to the organization at the time of inclusion.
• Evaluating the economic impact of early palliative care in patients with metastatic or advanced cancer through a medico-economic analysis combining cost-effectiveness and cost-utility analysis.
• Evaluating interactions between the various stakeholders (palliative care physicians, supportive care physicians, oncologists).

Inclusion Criteria:

• Subjects aged 18 years and older;
• Diagnosed with metastatic or locally advanced digestive, gynecological, ENT, or sarcoma cancer;
• Currently undergoing systemic palliative treatment (no prospect of cure);
• Hospitalized on an unscheduled basis (i.e., unplanned hospitalization for scheduled oncology treatments);
• Patient covered by the French social security system;
• Informed consent, written and signed.

Exclusion Criteria:

• PS (WHO) = 4;
• Patient receiving end-of-life care;
• Patient opposed to the use of medical data for research purposes;
• Person deprived of liberty or under guardianship;
• Inability to undergo medical monitoring for the trial for geographical, social, or psychological reasons.