Abstract
<title>Abstract</title> <p>Purpose Upper gastrointestinal (UGI) cancer carries a poor prognosis. A substantial proportion of patients are ineligible for curative treatment and are considered too vulnerable for oncological therapy. Hence, best supportive care (BSC) focusing on symptom management and quality-of-life preservation is often recommended. Structured follow-up has previously been shown to benefit patients receiving BSC, yet such a follow-up program is of limited availability. This study aimed to characterize symptom burden, health-care needs and survival among patients with UGI cancer recommended BSC. Methods This retrospective registry-based study included patients discussed at the regional multidisciplinary team (MDT) meeting at Sahlgrenska University Hospital between 2018 and 2021 who were recommended BSC without prior curative or palliative tumor-directed treatment. Data on symptom burden, interventions, inpatient care and survival were extracted from medical records. Results Three hundred and fifty-five patients were included. Mean age was 79.3 years and 52% of the patients were male. The overall symptom burden was high, with pain, weight loss and nausea being the most frequently recorded symptoms. Median survival from the MDT recommendation of BSC was 69 days. Eighty-two percent of the patients required at least one hospital admission after the MDT and the mean duration of inpatient care was 14 days. Conclusion Patients with UGI cancer receiving BSC demonstrate a high symptom burden and substantial need for hospital-based care along with a short overall survival. We hypothesize that structured follow-up initiated after the BSC decision may improve patient-centered outcomes while reducing unplanned admissions.</p>