Comparison of patient-reported outcomes and healthcare utilization between metastatic colorectal cancer patients receiving systemic therapy with or without concurrent palliative care support: a retrospective cohort study.

BACKGROUND: Patients with metastatic colorectal cancer (mCRC) experience substantial symptom burden, yet evidence on the integration of specialist palliative care (PC) in real-world settings remains limited. We assessed the impact of concurrent PC on patient-reported outcomes and healthcare utilization. OBJECTIVE: To evaluate the impact of integrating professional palliative care (PC) with standard systemic therapy on patient-reported outcomes, medical resource utilization, and overall survival (OS) in metastatic colorectal cancer (mCRC). METHODS: This retrospective cohort study included 201 mCRC patients receiving systemic therapy (Jan 2023-Jan 2025), of whom 69 received concurrent multidisciplinary PC (combined group) and 132 received standard care alone (non-combined group). We evaluated pain (NRS), clinically documented clinically documented emotional distress (diagnosis or medication use), treatment goal consistency, unplanned hospitalizations, emergency visits, end-of-life chemotherapy, and OS. The study was approved by the institutional ethics committee, which waived the requirement for informed consent due to the retrospective design. Statistical analyses used chi-square, Mann-Whitney U, and Cox regression. Two-sided P<0.05 was significant. RESULTS: At baseline, the combined group was older (median age higher, P = 0.002), had a greater proportion with ECOG PS≥2 (P = 0.008), and had a higher Charlson comorbidity index (P<0.001). Despite these disadvantages, they reported significantly greater pain reduction (P<0.001), lower clinically documented emotional distress rates (P = 0.007), and higher treatment goal consistency (P<0.001). Unplanned readmissions, emergency department visits, and chemotherapy within 30 days of death were all significantly lower (each P ≤ 0.001). Multivariate logistic regression confirmed that PC independently reduced the risk of clinically documented emotional distress (adjusted OR 0.42, P = 0.008) and increased goal consistency (OR 7.85, P<0.001). Overall survival did not differ between groups (median 19.1 vs 18.3 months; HR 0.92, P = 0.632). CONCLUSION: Integrating professional PC into standard mCRC management significantly enhances symptom relief, treatment goal alignment, and reduces aggressive end-of-life interventions without affecting survival. These findings strongly support the routine incorporation of multidisciplinary PC as a core component of high-quality cancer care, improving patient-centered outcomes and promoting efficient resource utilization. Early PC integration aligns with guideline recommendations and holds promise for cost-effective cancer care delivery.