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- Title
A Prognostic Model to Facilitate Palliative Care Referral in Oncology Outpatients.
- Authors
Yu Jung Kim; Yusuke Hiratsuka; Sang-Yeon Suh; Beodeul Kang; Si Won Lee; Hong-Yup Ahn; Koung Jin Suh; Ji-Won Kim; Se Hyun Kim; Jin Won Kim; Keun-Wook Lee; Jee Hyun Kim; Jong Seok Lee
- Abstract
Purpose We aimed to develop a prognostic model to assist palliative care referral at least 3 months before death in advanced cancer patients treated at an outpatient medical oncology clinic. Materials and Methods In this prospective cohort study, a total of 200 patients were enrolled at a tertiary cancer center in South Korea. The major eligibility criterion was an expected survival of less than a year as estimated by their oncologists. We analyzed the influences of known prognostic factors along with chemotherapy status, mid-arm circumference, and triceps skinfold thickness on survival time. Results The mean age of the patients was 64.5 years, 36% were female, and the median survival time was 7.6 months. In the multivariate analysis, we found six significant factors related to poor survival: a poor Eastern Cooperative Oncology Group (ECOG) performance status (≥ 2), not undergoing chemotherapy, anorexia, a low lymphocyte level (< 12%), a high lactate dehydrogenase (LDH) level (≥ 300 IU/L), and a low mid-arm circumference (< 23 cm). We developed a prognostic model (score, 0-8.0) to predict 3-month survival based on the multivariate analysis. Patients who scored ≥ 4.0 points had a short survival of less than 3 months (p < 0.001). The discriminating ability of the prognostic model using the area under the receiver operating characteristic curve was 0.88. Conclusion The prognostic model using ECOG performance status, chemotherapy status, anorexia, lymphocytes, LDH, and mid-arm circumference can predict 3-month survival in medical oncology outpatients. It can alert oncologists to refer patients to palliative care specialists before it is too late.
- Subjects
SOUTH Korea; PROGNOSTIC models; PALLIATIVE treatment; CANCER treatment; RECEIVER operating characteristic curves; CANCER patients
- Publication
Cancer Research & Treatment, 2022, Vol 54, Issue 2, p621
- ISSN
1598-2998
- Publication type
Article
- DOI
10.4143/crt.2021.483