Validation of the Prognosis in Palliative Care Study Predictor Models in Terminal Cancer Patients

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Prognosis in Palliative Care Study (PiPS) predictor models were developed in 2011 to estimate the survival of terminal cancer patients in the United Kingdom. The aim of this study was to validate the PiPS model for terminal cancer patients in Korea, and evaluate its value in clinical practice.

Methods

This study included 202 advanced cancer patients who were admitted to the cancer hospital's palliative care ward from November 2011 to February 2013. On admission, physicians recorded the PiPS-A, PiPS-B, and doctor's survival estimates in inpatients.

Results

The median survival across PiPS-A categories was 9, 28, and 33 days, and the median survival across PiPS-B was 9.5, 27, and 43 days. The median actual survival was 25 days; overall accuracy between the PiPS-A, PiPS-B, doctor's estimates of survival, and actual survival was 52.0%, 49.5%, and 46.5%, respectively. The PiPS-A and PiPS-B groups for survival in 'days' showed a sensitivity of 48.4% and 64.1%, and specificity of 87.7%, and 77.5%, respectively. The PiPS-A and PiPS-B groups for survival in 'weeks' showed a sensitivity of 59.2%, and 44.7%, and specificity of 61.6%, and 64.7%, respectively. The PiPS-A and PiPS-B 'months' group showed a sensitivity of 37.1% and 37.1%, and specificity of 74.9% and 78.4%, respectively. The 'weeks' and 'months' groups showed significantly prolonged survival rates than 'days' group did in both PiPS-A and PiPS-B, by the Kaplan-Meier method.

Conclusion

The PiPS predictor models effectively predicted the survival ≥14 days in terminal cancer patients, and were superior to doctor's estimates.

Related collections

Most cited references 25

Record: found
Abstract: found
Article: not found

Cancer statistics in Korea: incidence, mortality, survival and prevalence in 2010.

Kyu-Won Jung, Young-Joo Won, Hyun-Joo Kong … (2013)

This article gives an overview of nationwide cancer statistics, including incidence, mortality, survival and prevalence, and their trends in Korea based on 2010 cancer incidence data. Incidence data from 1993 to 2010 were obtained from the Korea National Cancer Incidence Database, and vital status was followed until 31 December 2011. Mortality data from 1983 to 2010 were obtained from Statistics Korea. Crude and age-standardized rates for incidence, mortality, prevalence, and relative survival were calculated. In total, 202,053 cancer cases and 72,046 cancer deaths occurred during 2010, and 960,654 prevalent cancer cases were identified in Korea as of 1 January 2011. The incidence of all cancers combined showed an annual increase of 3.3% from 1999 to 2010. The incidences of liver and cervical cancers have decreased while those of thyroid, breast, prostate and colorectal cancers have increased. Notably, thyroid cancer, which is the most common cancer in Korea, increased by 24.2% per year rapidly in both sexes. The mortality of all cancers combined showed a decrease by 2.7% annually from 2002 to 2010. Five-year relative survival rates of patients who were diagnosed with cancer from 2006 to 2011 had improved by 22.9% compared with those from 1993 to 1995. While the overall cancer incidence in Korea has increased rapidly, age-standardized cancer mortality rates have declined since 2002 and survival has improved.

0 comments Cited 195 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Prognostic factors in advanced cancer patients: evidence-based clinical recommendations--a study by the Steering Committee of the European Association for Palliative Care.

Steffen Eychmueller, Bert Broeckaert, Stein Kaasa … (2005)

To offer evidence-based clinical recommendations concerning prognosis in advanced cancer patients. A Working Group of the Research Network of the European Association for Palliative Care identified clinically significant topics, reviewed the studies, and assigned the level of evidence. A formal meta-analysis was not feasible because of the heterogeneity of published studies and the lack of minimal standards in reporting results. A systematic electronic literature search within the main available medical literature databases was performed for each of the following four areas identified: clinical prediction of survival (CPS), biologic factors, clinical signs and symptoms and psychosocial variables, and prognostic scores. Only studies on patients with advanced cancer and survival < or = 90 days were included. A total of 38 studies were evaluated. Level A evidence-based recommendations of prognostic correlation could be formulated for CPS (albeit with a series of limitations of which clinicians must be aware) and prognostic scores. Recommendations on the use of other prognostic factors, such as performance status, symptoms associated with cancer anorexia-cachexia syndrome (weight loss, anorexia, dysphagia, and xerostomia), dyspnea, delirium, and some biologic factors (leukocytosis, lymphocytopenia, and C-reactive protein), reached level B. Prognostication of life expectancy is a significant clinical commitment for clinicians involved in oncology and palliative care. More accurate prognostication is feasible and can be achieved by combining clinical experience and evidence from the literature. Using and communicating prognostic information should be part of a multidisciplinary palliative care approach.

0 comments Cited 142 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

The Palliative Prognostic Index: a scoring system for survival prediction of terminally ill cancer patients.

S. Inoue, S Chihara, J Tsunoda … (1999)

Although accurate prediction of survival is essential for palliative care, few clinical methods of determining how long a patient is likely to live have been established. To develop a validated scoring system for survival prediction, a retrospective cohort study was performed with a training-testing procedure on two independent series of terminally ill cancer patients. Performance status (PS) and clinical symptoms were assessed prospectively. In the training set (355 assessments on 150 patients) the Palliative Prognostic Index (PPI) was defined by PS, oral intake, edema, dyspnea at rest, and delirium. In the testing sample (233 assessments on 95 patients) the predictive values of this scoring system were examined. In the testing set, patients were classified into three groups: group A (PPI 4.0). Group B survived significantly longer than group C, and group A survived significantly longer than either of the others. Also, when a PPI of more than 6 was adopted as a cut-off point, 3 weeks' survival was predicted with a sensitivity of 80% and a specificity of 85%. When a PPI of more than 4 was used as a cutoff point, 6 weeks' survival was predicted with a sensitivity of 80% and a specificity of 77%. In conclusion, whether patients live longer than 3 or 6 weeks can be acceptably predicted by PPI.

0 comments Cited 134 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Korean J Fam Med

Journal ID (iso-abbrev): Korean J Fam Med

Journal ID (publisher-id): KJFM

Title: Korean Journal of Family Medicine

Publisher: The Korean Academy of Family Medicine

ISSN (Print): 2005-6443

ISSN (Electronic): 2092-6715

Publication date (Print): November 2014

Publication date (Electronic): 21 November 2014

Volume: 35

Issue: 6

Pages: 283-294

Affiliations

Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

[1 ]Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.

Author notes

Corresponding Author: Jung-Kwon Lee. Tel: +82-2-3410-2441, Fax: +82-2-3410-0388, jkwonL@ 123456smc.samsung.co.kr

Article

DOI: 10.4082/kjfm.2014.35.6.283

PMC ID: 4242906

PubMed ID: 25426276

SO-VID: 0a6a0a6f-e249-4691-8693-650a24def071

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 20 August 2013

Date accepted : 07 October 2014

Comments

Comment on this article

scite_

Cited by 13

See all cited by

Most referenced authors 413

See all reference authors

- Version 1
- Version 1

Validation of the Prognosis in Palliative Care Study Predictor Models in Terminal Cancer Patients

Read this article at

Abstract

Background

Methods

Results

Conclusion

Related collections

Karger: Oncology

Most cited references 25

Cancer statistics in Korea: incidence, mortality, survival and prevalence in 2010.

Prognostic factors in advanced cancer patients: evidence-based clinical recommendations--a study by the Steering Committee of the European Association for Palliative Care.

The Palliative Prognostic Index: a scoring system for survival prediction of terminally ill cancer patients.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 220

Cited by 13

Most referenced authors 413