Development of a predicting tool for survival of terminally ill cancer patients.
OBJECTIVE
To develop a predicting tool for survival of terminally ill cancer patients.


METHODS
This prospective, multicenter study was composed of two cohorts of samples: development and test. In the development sample of terminally ill cancer patients, 32 candidate predictors were studied to develop a new tool, Japan Palliative Oncology Study-Prognostic Index using the Cox proportional hazard model. Then the test sample was studied to validate Japan Palliative Oncology Study-Prognostic Index and compared it with the conventional predicting tools, such as palliative prognostic score and simplified palliative prognostic index.


RESULTS
Five significant predictors, physician's clinical prediction of survival, consciousness, pleural effusion, white blood cell count and lymphocyte % were derived from the analysis of 201 patients, and Japan Palliative Oncology Study-Prognostic Index was developed using these predictors. It could divide patients into three risk groups: low (A), intermediate (B) and high (C). Median survival times for Groups A, B and C were 51, 35 and 16 days, respectively. Survival probability for more than 30 days for Groups A, B and C in the development sample was 78%, 61% and 16%, respectively. Japan Palliative Oncology Study-Prognostic Index was studied in subsequent 208 patients for the test sample, and constant results (median survival times for Groups A, B and C; 67, 31 and 10 days, and survival probability for more than 30 days for Groups A, B and C; 81, 48 and 11%) were obtained. Palliative prognostic score can also predict three risk groups well, but simplified palliative prognostic index could not discriminate low risk from intermediate risk group.


CONCLUSIONS
Japan Palliative Oncology Study-Prognostic Index, a tool to predict survival, has been developed. Its reliability should be confirmed further in the future study, comparing with palliative prognostic score.
Hyodo
Ichinosuke
I
Division of Gastroenterology, Tsukuba University Graduate School of Comprehensive Human Sciences, Tsukuba 305-8575, Japan. ihyodo@md.tsukuba.ac.jp
Morita
Tatsuya
T
Adachi
Isamu
I
Shima
Yasuo
Y
Yoshizawa
Akitaka
A
Hiraga
Kazuaki
K
D000368:Aged; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D010166:Palliative Care; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D016019:Survival Analysis; D013727:Terminal Care