Patients’ Trajectory With Lung Cancer From Treatment Initiation to End-Of-Life - A Retrospective Cohort Study

Sep 21, 2026

This retrospective cohort study describes the course of lung cancer patients from treatment initiation to end-of-life using Japan’s National Health Insurance and Advanced Elderly Medical Service claims data. The analysis included newly diagnosed patients hospitalized at an urban university hospital from April 2013 to March 2021, assessing treatment pathways and end-of-life care and related clinical factors. Among 818 treated patients, end-of-life assessment covered 200 cases, with PCU use peaking near death and fewer deaths occurring at home.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Introduction

End-of-life care need in lung cancer

Preferred place of death and role of PCU

Limits of existing research and study rationale

Methods

Data source and cohort selection

Outcomes evaluated

Results

Treatment patterns

Time from initial treatment to death

Place of death and end-of-life care patterns

Conclusion

| Patients’ Trajectory With Lung Cancer From Treatment Initiation to End-Of-Life: A Retrospective Cohort Study Using Claims Data in Japan | Cancer Control Volume 31: 1–10
© The Author(s) 2024
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[DOI: 10.1177/10732748241305234](DOI: 10.1177/10732748241305234)[ ](DOI: 10.1177/10732748241305234)[journals.sagepub.com/home/ccx](journals.sagepub.com/home/ccx)

| | --- | --- | | Yuri Ogura, MD 1 􀀁, Masahiro Iwasaku, MD, PhD1 􀀁, Mami Ishida, MD, PhD2 􀀁 ,
Yuki Katayama, MD, PhD 1, Naoya Nishioka, MD, PhD 1, Kenji Morimoto, MD, PhD 1, Chie Yamamoto, MD 1, Shinsaku Tokuda, MD, PhD 1, Yoshiko Kaneko, MD, PhD 1, Tadaaki Yamada, MD, PhD 1, Hideya Yamazaki, MD, PhD3, Masayoshi Inoue, MD, PhD4, Hiroshi Ikai, MD, PhD2 􀀁, and Koichi Takayama, MD, PhD1
Abstract
Introduction: This study aimed to describe the course of patients with lung cancer from treatment initiation to end-of-life.
Methods: This retrospective cohort study used Claims Data from the National Health Insurance and Advanced Elderly Medical Service System. We analyzed data from patients newly diagnosed with lung cancer between April 2013 and March 2021 who had been hospitalized at our University Hospital in urban area. We evaluated (1) treatment courses of these patients, and (2) end-oflife care and clinical factors related to end-of-life care.
Results: A total of 818 patients who were diagnosed with lung cancer and received lung cancer treatment were included, of whom 200 were assessed for end-of-life. During the study period, 464 patients underwent surgery, while 308 received chemotherapy without undergoing surgery. The patients generally received lung cancer treatment within 2 years. The median time from initial treatment to death was 13 months for deceased patients. Patients in the palliative care unit (PCU) constituted 9% at 30 days before death, 25% at 7 days before death, and 40.5% on the day of death, whereas only 15% died at home. The prevalence of end-of-life care in the home/PCU was elevated among patients receiving molecular targeted drugs and in the female group.
Conclusion: This study highlighted the patterns of end-of-life care following lung cancer treatment by using Claims Data. PCU utilization was concentrated in the period shortly before death, with fewer patients passing away at home. End-of-life care maybe inﬂuenced by clinical factors, including the type of lung cancer treatment received, which may change the place of care.
Keywords
lung cancer, end-of-life care, hospice use, palliative care, administrative data, Japan
Received August 30, 2024. Received revised October 31, 2024. Accepted for publication November 19, 2024. | | | 1 Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
2Department of Medical Informatics and Clinical Epidemiology, Kyoto Prefectural University of Medicine, Kyoto, Japan 3Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan 4Division of Thoracic Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
Corresponding Author:
Masahiro Iwasaku, Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyotoshi, Kyoto, 602-8566, Japan.
[Email:](Email: miwasaku@koto.kpu-m.ac.jp)[ miwasaku@koto.kpu-m.ac.jp](Email: miwasaku@koto.kpu-m.ac.jp) | | Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as speciﬁed on the SAGE and Open Access pages ([https://us.sagepub.

FAQs

What was the purpose of this study on lung cancer patients?

To describe the trajectory of patients with lung cancer from treatment initiation through end-of-life, including end-of-life care and related clinical factors.

How was the study conducted and what data source was used?

The study used claims data from Japan’s National Health Insurance and Advanced Elderly Medical Service System, analyzing newly diagnosed patients hospitalized at an urban university hospital between April 2013 and March 2021.

What did the study find about the place of death and PCU use?

PCU utilization increased closer to death (9% at 30 days, 25% at 7 days, and 40.5% on the day of death), while only 15% of patients died at home. End-of-life care in the home/PCU was higher among patients receiving molecular targeted drugs and in the female group.

Sep 21, 2026

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