Prognosis prediction for end-stage pancreatic cancer with home medical care: A retrospective cohort study conducted at multiple institutions in Hiroshima

Abstract Background Home medical care provision has become more significant as the Japanese population continues to age. However, the number of patients with end-stage pancreatic cancer receiving home medical care remains limited, regardless of the patients’ strong preference for home medical care. Additionally, prognostic prediction in patients with end-stage pancreatic cancer receiving home medical care is not well validated, which limits the ability of clinicians to plan effective palliative interventions. Therefore, this study aimed to identify the prognostic factors associated with overall survival (OS) in patients with end-stage pancreatic cancer receiving home medical care and to develop a new prognostic scoring system. Methods This nine-center, retrospective study included patients with end-stage pancreatic cancer who were treated with home medical care between 2021 and 2025 in Japan. Univariate and multivariate analyses were performed to identify independent prognostic factors associated with OS. A prognostic scoring system was developed based on the factors identified in the multivariate analysis. Results In total, 168 participants (76 men and 92 women) were included in this study. The median OS with home medical care was 30 days. Multivariate analysis revealed that a history of opioid use before the initiation of home medical care, the presence of peritoneal dissemination, and a modified Glasgow Prognostic Score (mGPS) of 2 were independently associated with poor OS at home. Stratification based on the above factors demonstrated that patients presenting with two or more risk factors had significantly worse home survival than those with one or no risk factors (24 versus 45 days, p < 0.001). Conclusions This study identified prior opioid use, peritoneal dissemination, and a mGPS of 2 as independent risk factors for OS in patients with end-stage pancreatic cancer receiving home medical care. These results indicate that assessing these factors may aid healthcare providers in making informed decisions and optimizing supportive care strategies tailored to patient prognosis in the home medical care setting.