{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:59:48Z","timestamp":1785513588876,"version":"3.56.0"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"crossref","award":["CNPq, 313047\/2023-5"],"award-info":[{"award-number":["CNPq, 313047\/2023-5"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>High-grade gliomas (HGG) have a poor prognosis and high symptom burden, yet palliative care (PC) integration remains limited. We evaluated temporal changes in PC referral and assessment patterns at a Brazilian tertiary center and explored prognostic factors for survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a non-concurrent retrospective cohort of 117 adults with HGG who underwent surgery between 2017 and 2023. Primary outcomes included rates of PC referral and effective assessment, time to referral, and functional status (Karnofsky Performance Status, KPS) at referral. Secondary outcomes included overall survival (OS) and identification of prognostic factors using Cox regression analysis. Temporal trends were analyzed using the Cochran-Armitage test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PC referral increased from 21.1% (2017) to 73.7% (2023) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and effective assessment increased from 21.1% to 47.4% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.048). Median Karnofsky Performance Status at referral improved over time (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.011). In multivariate analysis, baseline clinical factors (older age and lower preoperative KPS) predicted earlier mortality; PC referral and effective assessment were not independently associated with survival after adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Over seven years, a significant increase in PC referrals and an improvement in functional status at the time of PC access were observed. Preoperative functional status was the main determinant of survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091261473884","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:10:52Z","timestamp":1785388252000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal Trends in Palliative Care Integration for High-Grade Glioma: A Seven-Year Retrospective Cohort Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7395-3633","authenticated-orcid":false,"given":"Eduardo Abr\u00e3o Sp\u00ednola","family":"Rezk","sequence":"first","affiliation":[{"name":"S\u00e3o Paulo State University (UNESP)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8568-1937","authenticated-orcid":false,"given":"Mariana Soares","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"S\u00e3o Paulo State University (UNESP)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6130-5150","authenticated-orcid":false,"given":"Pablo Afonso","family":"Melo","sequence":"additional","affiliation":[{"name":"S\u00e3o Paulo State University (UNESP)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thays Antunes","family":"Da Silva","sequence":"additional","affiliation":[{"name":"S\u00e3o Paulo State University (UNESP)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3878-3306","authenticated-orcid":false,"given":"Laura Cardia Gomes","family":"Lopes","sequence":"additional","affiliation":[{"name":"S\u00e3o Paulo State University (UNESP)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6436-9307","authenticated-orcid":false,"given":"Pedro Tadao","family":"Hamamoto Filho","sequence":"additional","affiliation":[{"name":"S\u00e3o Paulo State University (UNESP)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noad149"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043330"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.18718"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nop045"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2015.01.002"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-017-2484-y"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S65874"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.1474"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2925"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000678"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62416-2"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.16840"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/nop\/npv049"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/1756-9966-31-1"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-013-2077-6"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2013.001130"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30577-0"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-013-2088-3"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-013-1330-x"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1590\/0034-7167-2018-0718"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noaa200"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2021.100066"},{"key":"e_1_3_8_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.9.704"},{"key":"e_1_3_8_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/nop\/npac026"},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.5737\/23688076334436"},{"key":"e_1_3_8_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noaf043"},{"key":"e_1_3_8_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/nop\/npw022"},{"key":"e_1_3_8_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30345-5"},{"key":"e_1_3_8_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noaf230"},{"key":"e_1_3_8_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/noajnl\/vdaf064"},{"key":"e_1_3_8_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nov156"},{"key":"e_1_3_8_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/noajnl\/vdac114"},{"key":"e_1_3_8_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4344"},{"key":"e_1_3_8_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-026-01987-4"},{"key":"e_1_3_8_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163231152526"},{"key":"e_1_3_8_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-013-1263-7"},{"key":"e_1_3_8_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28628"},{"key":"e_1_3_8_39_2","doi-asserted-by":"publisher","DOI":"10.21037\/apm-20-768"},{"key":"e_1_3_8_40_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2001.95.2.0190"},{"key":"e_1_3_8_41_2","doi-asserted-by":"publisher","DOI":"10.3171\/2025.1.JNS242671"},{"key":"e_1_3_8_42_2","doi-asserted-by":"publisher","DOI":"10.1093\/nop\/npaf050"},{"key":"e_1_3_8_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-022-01210-6"},{"key":"e_1_3_8_44_2","doi-asserted-by":"publisher","DOI":"10.1093\/nop\/npaa077"},{"key":"e_1_3_8_45_2","doi-asserted-by":"publisher","DOI":"10.1093\/nop\/npac039"},{"key":"e_1_3_8_46_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-025-05377-3"}],"container-title":["American Journal of Hospice and Palliative Medicine\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10499091261473884","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10499091261473884","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10499091261473884","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:18:22Z","timestamp":1785511102000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10499091261473884"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,29]]},"references-count":45,"alternative-id":["10.1177\/10499091261473884"],"URL":"https:\/\/doi.org\/10.1177\/10499091261473884","relation":{},"ISSN":["1049-9091","1938-2715"],"issn-type":[{"value":"1049-9091","type":"print"},{"value":"1938-2715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,29]]},"article-number":"10499091261473884"}}