title: The Use of the Chuang's Prognostic Scale to Predict the Survival of Metastatic Colorectal Cancer Patients Receiving Palliative Systemic Anticancer Therapy.
abstract: BACKGROUND
  With the increasing number of agents active against cancer, advanced cancer patients including metastatic colorectal cancer (mCRC) patients may continue receiving palliative systemic anticancer therapy (PSAT) near the end-of-life. Validated palliative prognostic models, such as the Chuang's prognostic scale (CPS), may be helpful in identifying mCRC patients with limited survival who are unlikely to benefit from PSAT.
  
  
  OBJECTIVE
  To test the ability of the CPS to predict the survival of mCRC under treatment with PSAT.
  
  
  METHODS
  CPS was prospectively assessed in 36 mCRC patients who were receiving PSAT. The scale is based on eight items: ascites, edema, cognitive impairment, liver and lung metastases, performance status, tiredness, and weight loss. The total CPS score ranges from 0 to 8.5 with the higher score indicating worse prognosis.
  
  
  RESULTS
  Patients were divided into two groups using a CPS cutoff score of 5, Group 1 with a CPS score ≤5 and Group 2 with a CPS score >5. Using this cutoff value, 3-month mortality was predicted with a positive predictive value of 71%, a negative predictive value of 77%, a sensitivity of 67%, a specificity of 81% and an overall accuracy of 75%. Group 1 patients had a longer median survival of 149 days (95% confidence interval [CI]: 82-216) in comparison to Group 2 patients who had a median survival of 61 days (95% CI: 35-87). The difference in survival was statistically significant (P = 0.01).
  
  
  CONCLUSIONS
  CPS may be useful in identifying mCRC patients with limited survival who are unlikely to benefit from PSAT.
authors: Kasr Al Ainy Center of Clinical Oncology and Nuclear Medicine, Palliative Medicine Unit, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt.
authors: Samy A
authors: SA
authors: Alsirafy
authors: Department of Clinical Oncology, Kasr Al Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt.
authors: Omar
authors: O
authors: Zaki
authors: Department of Clinical Oncology, Kasr Al Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt.
authors: Amr Y
authors: AY
authors: Sakr
authors: Kasr Al Ainy Center of Clinical Oncology and Nuclear Medicine, Palliative Medicine Unit, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt.
authors: Dina E
authors: DE
authors: Farag
authors: Kasr Al Ainy Center of Clinical Oncology and Nuclear Medicine, Palliative Medicine Unit, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt.
authors: Wessam A
authors: WA
authors: El-Sherief
authors: Department of Clinical Oncology, Kasr Al Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt; Al Amal Oncology Center, Aden, Yemen.
authors: Abha A
authors: AA
authors: Mohammed
keywords: Chuang's prognostic scale; End-of-life care; Metastatic colorectal cancer; Palliative systemic anticancer therapy; Prognosis