Hospital-Based Palliative Care for Patients with Advanced Thoracic Malignancies: A Retrospective Cohort from a Tertiary Center

Purpose Patients with advanced thoracic malignancies carry heavy symptom burden and decline rapidly, yet hospital-based palliative care (PC) units are uncommon. We report outcomes of patients admitted to the University Hospital of Modena’s PC ward. Methods We conducted a retrospective, observational study of consecutive patients with advanced thoracic malignancies admitted to the PC ward between 2022 and 2024. Demographics, disease characteristics, most recent oncologic treatment, hospitalization details and outcomes were collected. Descriptive statistics, χ² test, Cox models and Kaplan–Meier were used. Results We included 144 patients (42.4% female; median age 75 years). NSCLC was the most frequent histology (68.1%), followed by SCLC (15.3%); 11.8% lacked histologic confirmation due to clinical deterioration. In the 30 days prior to admission, 36.1% received a systemic anticancer treatment and 72.9% had not received home-based PC. Most patients were transferred from other hospital wards; 22.2% were referred from home or other facilities. The median interval from diagnosis to PC admission was 4.8 months (95% CI, 1.1–11.7). Median overall survival (OS) from admission was 14 days (95% CI, 10–18). Palliative sedation was required in 25.7% of patients, mainly for refractory dyspnea and agitation. Overall, 29.9% were discharged after stabilization; discharge was more likely without target symptoms on PERSONS score (60.5% vs 37.6%; p = 0.02) and was associated with longer OS (45 vs 8 days; HR 0.12; 95% CI 0.08–0.21; p < 0.001). Conclusion A hospital-based PC ward offers symptoms management and end-of-life care despite late referrals. The inpatient setting ensures continuity of care and works as a discharge-oriented ward.