Use of palliative care in patients with hematological tumors versus patients with solid tumors in our setting. Are there differences?

Introduction: Patients with hematological malignancies (HM) tend to access palliative care (PC) services later and less frequently than those with solid tumors (ST), despite having similar needs. Objectives: This study compares PC utilization between both groups in a public hospital in the Community of Madrid. Material and method: A retrospective observational study was conducted including 5,188 patients (184 with HM and 5,004 with ST) managed by the PC unit between 2002 and 2023. Demographic, clinical, and care-related variables were analyzed, including symptoms, time in the PC program, sedation, and place of death. Results: HM patients were older (77.4 vs. 72.2 years; p < 0.001), entered PC later (1,206 vs. 773 days from diagnosis; p < 0.001), and stayed for a shorter period (82.6 vs. 129.2 days; p < 0.001). Symptom burden at referral was similar (HM: 95.1%; ST: 97.7%), but fatigue-anorexia-cachexia was more frequent in HM (19.6% vs. 5.2%; p < 0.001), while pain was more common in ST. Emergency admission was less frequent in HM (46.2% vs. 71.8%; p < 0.001). Most patients died in hospital (HM: 67.9%; ST: 58.5%; p = 0.012), with no significant differences in the need for palliative sedation. Conclusions: HM patients are referred to PC later and less often, remaining for shorter durations despite comparable symptom burden. Early and tailored integration of PC into hematologic care is essential to improve quality of life in advanced stages.