Les modes d'hospitalisation nécessaires pour une prise en charge de qualité en oncologie thoracique

The purpose of this study was to determine whether good-quality care for patients with lung cancer can be delivered without a full hospitalization unit. Our study included all consecutive untreated lung cancer patients admitted over a two-year period. The following criteria were analyzed retrospectively: residence, age, sex, histology, staging, treatments, administrative data during the first 6 months of treatment, place of death, and duration of last stay before death in the unit. Two hundred six patients were recorded. Twenty-eight percent of the patients had stage IIIB disease and 61% stage IV disease. The first treatment included: surgery (12%), chemotherapy (80%). During the first six months, the median number of hospitalizations was 8 and the median number of full hospitalization days was 17 compared with 6 days for one-day stays. The median duration of the first stay was 5 days whereas the duration of the last one was 3 days. During the first year, 71% of the patients dies: 36% in our unit (47% of them were inpatients for more than 6 days during their last stay). Diagnosis, initial treatment, management of treatment complications and supportive care are not compatible with weekly hospitalization. Full hospitalization is mandatory for good-quality care in a referral cancer unit.