Basic palliative care assessments in the treatment of urological oncology patients: A prospective cross-sectional study.

Abstract

e24069 Background: Current guidelines on palliative care in oncological patients recommend assessing physical, psychological, social, and spiritual needs as well as distress and information needs of patients and relatives. A validated tool frequently used for this purpose is the Edmonton Symptom Assessment Scale (ESAS). The MIDOS2 questionnaire is the validated German version of the ESAS. Though validated in cancer patients (pts) in general, the MIDOS2 has not yet been validated specifically in uro-oncological patients. Methods: Uro-oncological pts receiving systemic cancer therapy at a single academic center were enrolled in this prospective cross-sectional study. After consent, patients were screened with MIDOS2 as well as the Distress Thermometer (DT), G8 Questionnaire (G8), 6-Item Screener (SIS) and Mini Nutritional Assessment (MNA). Repeated screening was performed after 3 months (T3). Epidemiological and clinical data collected as well. Using the MIDOS2 cut-off of ≥8 points indicating need for palliative support, patients were grouped and DT, G8, 6IS and MNA results compared. MIDOS2 sum scores were additionally analyzed across tumor entities. Descriptive statistics, ANOVA, Mann–Whitney U, and Pearson/Spearman correlations were applied. Results: From 04/2025-01/2026, 133 patients were included (median age: 65 y, 119 male, 43 prostate cancer, 37 urothelial carcinoma, 24 renal cell carcinoma, 29 other). Comparing pts with low (0-7 points, n = 86) and high (³8 points n = 47) symptom burden values, DT (p = 0,002) MNA (p < 0,001) and G8 (p < 0,001) results were more frequently pathological in the high burden group. No significant correlation was found for the SIS. Symptom burden as assessed by MIDOS 2 was highest in weakness (mean 1,23) and lowest in vomit (mean 0,17). At data cut-off, 86/133 pts had assessments at T0 and T3 months (43/53 pts with T0 at any time of treatment, 43/80 pts with T0 before start of treatment). Comparing assessment at T3 to T0, 12 pts improved from the high to low symptom burden group, and 12 pts impaired regarding symptom burden, while 62 pts had no change. Comparing reassessment between pts tested at any time of treatment and tested before and after initiation of treatment, differences in improving and impairing rates were not observed. When analysing DT, MNA and G8 scores, improvement was more frequently observed. SIS remained unchanged. Conclusions: Uro-oncological pts often experience symptom burden detectable by MIDOS2, influenced by cancer type, treatment and patient-related factors. MIDOS2 total scores of 8 points or higher indicate further stress for the patient and should lead to the initiation of specialized palliative care. As symptom burden may vary during patient history, even within a limited time frame, repeat testing is reasonable.