Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study

Goals of work The goal of this study was to develop a new, objective prognostic score (OPS) for terminally ill cancer patients based on an integrated model that includes novel objective prognostic factors. Materials and methods A multicenter study of 209 terminally ill cancer patients from six train...

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Veröffentlicht in:Supportive care in cancer 2010-02, Vol.18 (2), p.151-157
Hauptverfasser: Suh, Sang-Yeon, Choi, Youn Seon, Shim, Jae Yong, Kim, Young Sung, Yeom, Chang Hwan, Kim, Daeyoung, Park, Shin Ae, Kim, Sooa, Seo, Ji Yeon, Kim, Su Hyun, Kim, Daegyeun, Choi, Sung-Eun, Ahn, Hong-Yup
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container_end_page 157
container_issue 2
container_start_page 151
container_title Supportive care in cancer
container_volume 18
creator Suh, Sang-Yeon
Choi, Youn Seon
Shim, Jae Yong
Kim, Young Sung
Yeom, Chang Hwan
Kim, Daeyoung
Park, Shin Ae
Kim, Sooa
Seo, Ji Yeon
Kim, Su Hyun
Kim, Daegyeun
Choi, Sung-Eun
Ahn, Hong-Yup
description Goals of work The goal of this study was to develop a new, objective prognostic score (OPS) for terminally ill cancer patients based on an integrated model that includes novel objective prognostic factors. Materials and methods A multicenter study of 209 terminally ill cancer patients from six training hospitals in Korea were prospectively followed until death. The Cox proportional hazard model was used to adjust for the influence of clinical and laboratory variables on survival time. The OPS was calculated from the sum of partial scores obtained from seven significant predictors determined by the final model. The partial score was based on the hazard ratio of each predictor. The accuracy of the OPS was evaluated. Main results The overall median survival was 26 days. On the multivariate analysis, reduced oral intake, resting dyspnea, low performance status, leukocytosis, elevated bilirubin, elevated creatinine, and elevated lactate dehydrogenase (LDH) were identified as poor prognostic factors. The range of OPS was from 0.0 to 7.0. For the above cutoff point of 3.0, the 3-week prediction sensitivity was 74.7%, the specificity was 76.5%, and the overall accuracy was 75.5%. Conclusions We developed the new OPS, without clinician’s survival estimates but including a new prognostic factor (LDH). This new instrument demonstrated accurate prediction of the 3-week survival. The OPS had acceptable accuracy in this study population (training set). Further validation is required on an independent population (testing set).
doi_str_mv 10.1007/s00520-009-0639-x
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Materials and methods A multicenter study of 209 terminally ill cancer patients from six training hospitals in Korea were prospectively followed until death. The Cox proportional hazard model was used to adjust for the influence of clinical and laboratory variables on survival time. The OPS was calculated from the sum of partial scores obtained from seven significant predictors determined by the final model. The partial score was based on the hazard ratio of each predictor. The accuracy of the OPS was evaluated. Main results The overall median survival was 26 days. On the multivariate analysis, reduced oral intake, resting dyspnea, low performance status, leukocytosis, elevated bilirubin, elevated creatinine, and elevated lactate dehydrogenase (LDH) were identified as poor prognostic factors. The range of OPS was from 0.0 to 7.0. For the above cutoff point of 3.0, the 3-week prediction sensitivity was 74.7%, the specificity was 76.5%, and the overall accuracy was 75.5%. Conclusions We developed the new OPS, without clinician’s survival estimates but including a new prognostic factor (LDH). This new instrument demonstrated accurate prediction of the 3-week survival. The OPS had acceptable accuracy in this study population (training set). Further validation is required on an independent population (testing set).</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-009-0639-x</identifier><identifier>PMID: 19381691</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Activities of Daily Living ; Adult ; Aged ; Analysis ; Anorexia - epidemiology ; Bilirubin ; Bilirubin - blood ; Biomarkers - blood ; C-Reactive Protein - metabolism ; Cancer ; Cancer patients ; Care and treatment ; Cognition Disorders - epidemiology ; Comorbidity ; Creatinine - blood ; Dyspnea - epidemiology ; Eating ; Female ; Follow-Up Studies ; Humans ; L-Lactate Dehydrogenase - blood ; Leukocytosis - epidemiology ; Male ; Medical prognosis ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Neoplasms - blood ; Neoplasms - mortality ; Nursing ; Nursing Research ; Oncology ; Oncology, Experimental ; Original Article ; Pain Medicine ; Palliative Care - statistics &amp; numerical data ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Rehabilitation Medicine ; Republic of Korea - epidemiology ; Survival Rate ; Terminal Care - statistics &amp; numerical data ; Terminal illnesses ; Terminally ill persons</subject><ispartof>Supportive care in cancer, 2010-02, Vol.18 (2), p.151-157</ispartof><rights>Springer-Verlag 2009</rights><rights>COPYRIGHT 2010 Springer</rights><rights>Springer-Verlag 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-d89c988ed8a5100b2d5034b0ef160afcd20d7486124993a4fd6fc4db37796c73</citedby><cites>FETCH-LOGICAL-c503t-d89c988ed8a5100b2d5034b0ef160afcd20d7486124993a4fd6fc4db37796c73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00520-009-0639-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00520-009-0639-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19381691$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Suh, Sang-Yeon</creatorcontrib><creatorcontrib>Choi, Youn Seon</creatorcontrib><creatorcontrib>Shim, Jae Yong</creatorcontrib><creatorcontrib>Kim, Young Sung</creatorcontrib><creatorcontrib>Yeom, Chang Hwan</creatorcontrib><creatorcontrib>Kim, Daeyoung</creatorcontrib><creatorcontrib>Park, Shin Ae</creatorcontrib><creatorcontrib>Kim, Sooa</creatorcontrib><creatorcontrib>Seo, Ji Yeon</creatorcontrib><creatorcontrib>Kim, Su Hyun</creatorcontrib><creatorcontrib>Kim, Daegyeun</creatorcontrib><creatorcontrib>Choi, Sung-Eun</creatorcontrib><creatorcontrib>Ahn, Hong-Yup</creatorcontrib><title>Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Goals of work The goal of this study was to develop a new, objective prognostic score (OPS) for terminally ill cancer patients based on an integrated model that includes novel objective prognostic factors. Materials and methods A multicenter study of 209 terminally ill cancer patients from six training hospitals in Korea were prospectively followed until death. The Cox proportional hazard model was used to adjust for the influence of clinical and laboratory variables on survival time. The OPS was calculated from the sum of partial scores obtained from seven significant predictors determined by the final model. The partial score was based on the hazard ratio of each predictor. The accuracy of the OPS was evaluated. Main results The overall median survival was 26 days. On the multivariate analysis, reduced oral intake, resting dyspnea, low performance status, leukocytosis, elevated bilirubin, elevated creatinine, and elevated lactate dehydrogenase (LDH) were identified as poor prognostic factors. The range of OPS was from 0.0 to 7.0. For the above cutoff point of 3.0, the 3-week prediction sensitivity was 74.7%, the specificity was 76.5%, and the overall accuracy was 75.5%. Conclusions We developed the new OPS, without clinician’s survival estimates but including a new prognostic factor (LDH). This new instrument demonstrated accurate prediction of the 3-week survival. The OPS had acceptable accuracy in this study population (training set). Further validation is required on an independent population (testing set).</description><subject>Activities of Daily Living</subject><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Anorexia - epidemiology</subject><subject>Bilirubin</subject><subject>Bilirubin - blood</subject><subject>Biomarkers - blood</subject><subject>C-Reactive Protein - metabolism</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Cognition Disorders - epidemiology</subject><subject>Comorbidity</subject><subject>Creatinine - blood</subject><subject>Dyspnea - epidemiology</subject><subject>Eating</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>L-Lactate Dehydrogenase - blood</subject><subject>Leukocytosis - epidemiology</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Neoplasms - blood</subject><subject>Neoplasms - mortality</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Oncology, Experimental</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Palliative Care - statistics &amp; 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Materials and methods A multicenter study of 209 terminally ill cancer patients from six training hospitals in Korea were prospectively followed until death. The Cox proportional hazard model was used to adjust for the influence of clinical and laboratory variables on survival time. The OPS was calculated from the sum of partial scores obtained from seven significant predictors determined by the final model. The partial score was based on the hazard ratio of each predictor. The accuracy of the OPS was evaluated. Main results The overall median survival was 26 days. On the multivariate analysis, reduced oral intake, resting dyspnea, low performance status, leukocytosis, elevated bilirubin, elevated creatinine, and elevated lactate dehydrogenase (LDH) were identified as poor prognostic factors. The range of OPS was from 0.0 to 7.0. For the above cutoff point of 3.0, the 3-week prediction sensitivity was 74.7%, the specificity was 76.5%, and the overall accuracy was 75.5%. Conclusions We developed the new OPS, without clinician’s survival estimates but including a new prognostic factor (LDH). This new instrument demonstrated accurate prediction of the 3-week survival. The OPS had acceptable accuracy in this study population (training set). Further validation is required on an independent population (testing set).</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>19381691</pmid><doi>10.1007/s00520-009-0639-x</doi><tpages>7</tpages></addata></record>
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subjects Activities of Daily Living
Adult
Aged
Analysis
Anorexia - epidemiology
Bilirubin
Bilirubin - blood
Biomarkers - blood
C-Reactive Protein - metabolism
Cancer
Cancer patients
Care and treatment
Cognition Disorders - epidemiology
Comorbidity
Creatinine - blood
Dyspnea - epidemiology
Eating
Female
Follow-Up Studies
Humans
L-Lactate Dehydrogenase - blood
Leukocytosis - epidemiology
Male
Medical prognosis
Medicine
Medicine & Public Health
Middle Aged
Neoplasms - blood
Neoplasms - mortality
Nursing
Nursing Research
Oncology
Oncology, Experimental
Original Article
Pain Medicine
Palliative Care - statistics & numerical data
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Rehabilitation Medicine
Republic of Korea - epidemiology
Survival Rate
Terminal Care - statistics & numerical data
Terminal illnesses
Terminally ill persons
title Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study
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