Objectives To assess EOL care in the last 30 days and place of death among gynecological cancer patients.

Methods This retrospective study included all gynecological cancer patients who died between Jan 1st 2015 and Dec 31st, 2017 in Oslo County. Descriptive statistics were used. P-values of <0.05 were considered statistically significant.

Results We included 215 patients, of those 53% ovarian-(OC), 30% endometrial- (EC), 14% cervical cancer (CC) and 3% with other gynecological cancers. 15% had more than 3 lines of treatment prior to death. In the last 30 days, 13% of patients received chemotherapy, 61% were admitted to hospital and 32% had a surgical intervention (drainage of pleural effusions, ascites, gastric probe, palliative surgery for bowel obstuction, venous access port ect.). Only 46% of the patients were referred to palliative care prior to death. A third of the patients died in hospital (33%), 26% in palliative care units, 22% in nursing homes while 7% died at home. CC patients were more often referred to palliative team (P<0.001). They were also using more opiates (88%) than OC and EC patients (73 and 66%; P<0.001) and were prescribed medication according to the Liverpool Care Pathway (LCP) in 67% compared to 29 and 42% in OC and EC patients. OC patients had more often chemotherapy (20%) and surgical interventions (43%) towards EOL (<0.001).

Conclusions Less than half of the patients received multidisciplinary care including palliative care towards EOL. Especially ovarian cancer patients may benefit from early integration of palliative care to avoid futile treatment towards EOL.