A Prognostic Model to Facilitate Palliative Care Referral in Oncology Outpatients
- Author:
Yu Jung KIM
1
;
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
Author Information
- Publication Type:Original Article
- From:Cancer Research and Treatment 2022;54(2):621-629
- CountryRepublic of Korea
- Language:English
-
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 6 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 (AUC) 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.
