scholarly journals Validation of the Palliative Prognostic Index, Performance Status–Based Palliative Prognostic Index and Chinese Prognostic Scale in a home palliative care setting for patients with advanced cancer in China

2020 ◽  
Author(s):  
Jun Zhou ◽  
Sitao Xu ◽  
Ziye Cao ◽  
Jing Tang ◽  
Xiang Fang ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Performance Status ◽  
Mainland China ◽  
Prognostic Index ◽  
Risk Groups ◽  
Palliative Care Setting ◽  
Palliative Prognostic Index

Abstract Background: The predictive value of the prognostic tool for patients with advanced cancer is uncertain in mainland China, especially in the home-based palliative care (HPC) setting. This study aimed to compare the accuracy of the Palliative Prognostic Index (PPI), the Performance Status–Based Palliative Prognostic Index (PS-PPI), and the Chinese Prognosis Scale (ChPS) for patients with advanced cancer in the HPC setting in mainland China.Methods: Patients with advanced cancer admitted to the hospice center of Yuebei People’s Hospital between January 2014 and December 2018 were retrospectively calculated the scores according to the three prognostic tools. The Kaplan-Meier method was used to compare survival times among different risk groups. Receiver operating characteristic curve analysis was used to assess the predictive value. The accuracy of 21-, 42- and 90-day survival was compared among the three prognostic tools. Results: A total of 1863 patients were included. Survival time among the risk groups of all prognostic tools was significantly different from each other except for the PPI. The AUROC of the ChPS was significantly higher than that of the PPI and PS-PPI for 7-, 14, 21-, 42-, 90-, 120-, 150- and 180-day survival (P <0.05). The AUROC of the PPI and PS-PPI were not significantly different from each other (P >0.05).Conclusions: The ChPS is more suitable than the PPI and PS-PPI for advanced cancer patients in the HPC setting. More researches are needed to verify the predictive value of the ChPS, PPI, and PS-PPI in the HPC setting in the future.

scholarly journals Validation of the Palliative Prognostic Index, Performance Status–Based Palliative Prognostic Index and Chinese Prognostic Scale in a home palliative care setting for patients with advanced cancer in China

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jun Zhou ◽  
Sitao Xu ◽  
Ziye Cao ◽  
Jing Tang ◽  
Xiang Fang ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Performance Status ◽  
Mainland China ◽  
Prognostic Index ◽  
Risk Groups ◽  
Palliative Care Setting ◽  
Palliative Prognostic Index

Abstract Background The predictive value of the prognostic tool for patients with advanced cancer is uncertain in mainland China, especially in the home-based palliative care (HPC) setting. This study aimed to compare the accuracy of the Palliative Prognostic Index (PPI), the Performance Status–Based Palliative Prognostic Index (PS-PPI), and the Chinese Prognosis Scale (ChPS) for patients with advanced cancer in the HPC setting in mainland China. Methods Patients with advanced cancer admitted to the hospice center of Yuebei People’s Hospital between January 2014 and December 2018 were retrospectively calculated the scores according to the three prognostic tools. The Kaplan-Meier method was used to compare survival times among different risk groups. Receiver operating characteristic curve analysis was used to assess the predictive value. The accuracy of 21-, 42- and 90-day survival was compared among the three prognostic tools. Results A total of 1863 patients were included. Survival time among the risk groups of all prognostic tools was significantly different from each other except for the PPI. The AUROC of the ChPS was significantly higher than that of the PPI and PS-PPI for 7-, 14, 21-, 42-, 90-, 120-, 150- and 180-day survival (P < 0.05). The AUROC of the PPI and PS-PPI were not significantly different from each other (P > 0.05). Conclusions The ChPS is more suitable than the PPI and PS-PPI for advanced cancer patients in the HPC setting. More researches are needed to verify the predictive value of the ChPS, PPI, and PS-PPI in the HPC setting in the future.

scholarly journals Validation of the Palliative Prognostic Index, Performance Status–based Palliative Prognostic Index and Chinese Prognostic Scale in a Home Palliative Care Setting for Patients With Advanced Cancer in China

2020 ◽  
Author(s):  
Jun Zhou ◽  
Sitao Xu ◽  
Ziye Cao ◽  
Jing Tang ◽  
Ling Qin ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Performance Status ◽  
Mainland China ◽  
Prognostic Index ◽  
Risk Groups ◽  
Palliative Care Setting ◽  
Palliative Prognostic Index

Abstract Background:Thepredictive value of theprognostic tool for patients with advanced cancer isuncertainin mainland China, especially in the home-based palliative care (HPC) setting. This study aimed to compare the accuracy of the Palliative Prognostic Index (PPI), the Performance Status–Based Palliative Prognostic Index (PS-PPI), and the Chinese Prognosis Scale (ChPS) for patients with advanced cancer in the HPC setting in mainland China.Methods:Patients with advanced cancer admitted to the hospice center of Yuebei People’s Hospital between January 2014 and December 2018 were retrospectively calculated the scores according to the three prognostic tools. The Kaplan-Meier method was used to compare survival times among different risk groups. Receiver operating characteristic curve analysis was used to assess the predictive value. The accuracy of 21-, 42- and 90-day survival was compared among the three prognostic tools.Results: A total of 1863 patients were included. Survival time among the risk groups of all prognostic tools was significantly different from each other except for the PPI. The AUROC of the ChPS was significantly higher than that of the PPI and PS-PPI for 7-, 14, 21-, 42-, 90-, 120-, 150- and 180-day survival (P <0.05). The AUROC of the PPI and PS-PPI were not significantly different from each other (P >0.05).Conclusions: The ChPS is more suitable than the PPI and PS-PPI for advanced cancer patients in the HPC setting. More researches are needed to verify the predictive value of the ChPS, PPI, and PS-PPI in the HPC setting in the future.

scholarly journals Validation of the Palliative Prognostic Index, Performance Status–Based Palliative Prognostic Index and Chinese Prognostic Scale in a Home Palliative Care Setting for Patients with Advanced Cancer in China

2020 ◽  
Author(s):  
Jun Zhou ◽  
Sitao Xu ◽  
Ziye Cao ◽  
Jing Tang ◽  
Ling Qin ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Performance Status ◽  
Mainland China ◽  
Prognostic Index ◽  
Risk Groups ◽  
Palliative Care Setting ◽  
Palliative Prognostic Index

Abstract Background: The predictive value of the prognostic tool for patients with advanced cancer is uncertain in mainland China, especially in the home-based palliative care (HPC) setting. This study aimed to compare the accuracy of the Palliative Prognostic Index (PPI), the Performance Status–Based Palliative Prognostic Index (PS-PPI), and the Chinese Prognosis Scale (ChPS) for patients with advanced cancer in the HPC setting in mainland China.Methods: Patients with advanced cancer admitted to the hospice center of Yuebei People’s Hospital between January 2014 and December 2018 were retrospectively calculated the scores according to the three prognostic tools. The Kaplan-Meier method was used to compare survival times among different risk groups. Receiver operating characteristic curve analysis was used to assess the predictive value. The accuracy of 21-, 42- and 90-day survival was compared among the three prognostic tools. Results: A total of 1863 patients were included. Survival time among the risk groups of all prognostic tools was significantly different from each other except for the PPI. The AUROC of the ChPS was significantly higher than that of the PPI and PS-PPI for 7-, 14, 21-, 42-, 90-, 120-, 150- and 180-day survival (P <0.05). The AUROC of the PPI and PS-PPI were not significantly different from each other (P >0.05).Conclusions: The ChPS is more suitable than the PPI and PS-PPI for advanced cancer patients in the HPC setting. More researches are needed to verify the predictive value of the ChPS, PPI, and PS-PPI in the HPC setting in the future.

scholarly journals Predicting survival in patients with advanced cancer in the last weeks of life: How accurate are prognostic models compared to clinicians’ estimates?

2019 ◽  
Vol 34 (1) ◽  
pp. 126-133 ◽  
Author(s):  
David Hui ◽  
Jeremy Ross ◽  
Minjeong Park ◽  
Rony Dev ◽  
Marieberta Vidal ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Prognostic Score ◽  
Prognostic Index ◽  
Prognostic Scores ◽  
Concordance Index ◽  
Prognostic Accuracy ◽  
Prediction Of Survival ◽  
Palliative Prognostic Index ◽  
Performance Scale

Background: It is unclear if validated prognostic scores such as the Palliative Performance Scale, Palliative Prognostic Index, and Palliative Prognostic Score are more accurate than clinician prediction of survival in patients admitted to an acute palliative care unit with only days of survival. Aim: We compared the prognostic accuracy of Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and clinician prediction of survival in this setting. Design: This is a pre-planned secondary analysis of a prospective study. Setting/participants: We assessed Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and clinician prediction of survival at baseline. We computed their prognostic accuracy using the Concordance index and area under the receiver operating characteristics curve for 7-, 14-, and 30-day survival. Results: A total of 204 patients were included with a median overall survival of 10 days (95% confidence interval: 8–11 days). The Concordance index for Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and clinician prediction of survival were 0.74, 0.71, 0.70, and 0.75, respectively. The areas under the curve for these approaches were 0.82–0.87 for 30-day survival, 0.75–0.80 for 14-day survival, and 0.74–0.81 for 7-day survival. The four prognostic approaches had similar accuracies, with the exception of 7-day survival in which clinician prediction of survival was significantly more accurate than Palliative Prognostic Score (difference: 7%) and Palliative Prognostic Index (difference: 8%). Conclusion: In patients with advanced cancer with days of survival, clinician prediction of survival and Palliative Performance Scale alone were as accurate as Palliative Prognostic Score and Palliative Prognostic Index. These four approaches may be useful for prognostication in acute palliative care units. Our findings highlight how patient population may impact the accuracy of prognostic scores.

Prognosis prediction with two calculations of Palliative Prognostic Index: further prospective validation in hospice cancer patients with multicentre study

2018 ◽  
Vol 9 (3) ◽  
pp. 326-331 ◽  
Author(s):  
Sivakumar Subramaniam ◽  
Pauline Dand ◽  
Martin Ridout ◽  
Declan Cawley ◽  
Sophie Miller ◽  
...  
Keyword(s):  
Palliative Care ◽  
Predictive Value ◽  
Prognostic Index ◽  
Discriminatory Ability ◽  
Prognostic Tool ◽  
Palliative Prognostic Index ◽  
Clinical Indices ◽  
The Uk ◽  
Sensitivity Specificity ◽  
Improved Accuracy

ObjectivesIn palliative care settings, predicting prognosis is important for patients and clinicians. The Palliative Prognostic Index (PPI), a prognostic tool calculated using clinical indices alone has been validated within cancer population. This study was to further test the discriminatory ability of the PPI (ie, its ability to determine whether a subject will live more or less than a certain amount of time) in a larger sample but with a palliative care context and to compare predictions at two different points in time.MethodsMulticentre, prospective, observational study in 10 inpatient hospices in the UK. The PPI score was calculated on the day of admission (PPI1) and again once on days 3–5 of inpatient stay (PPI2). Patients were followed up for 6 weeks or until death, whichever was earlier.ResultsOf the 1164 patients included in the study, 962 had both scores available. The results from PPI2 showed improved sensitivity, specificity, positive predictive value and negative predictive value compared with PPI1. For PPI1versus PPI2, area under receiver operator character curve (ROC) for <21 days were 0.73 versus 0.82 and for ≥42 days prediction 0.72 versus 0.80. The median survival days for patients with PPI1 ≤4, 4.5–6 and >6 were 38 (31 to 44), 17 (14 to 19) and 5 (4 to 7).ConclusionThis study showed improved discriminatory ability using the PPI score calculated between day 3and day5 of admission compared with that calculated on admission. This study further validated PPI as a prognostic tool within a palliative care population and showed recording at two time points improved accuracy.

scholarly journals Validation of the Simplified Palliative Prognostic Index to Predict Survival for Advanced Cancer Patients in Home Hospice Setting

2021 ◽  
Vol 42 (4) ◽  
pp. 274-280
Author(s):  
Hyeon-Jeong Yang ◽  
Seok-Joon Yoon ◽  
Jong-Sung Kim ◽  
Sung-Soo Kim ◽  
Jin-Gyu Jung ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Hospice Care ◽  
Characteristic Curve ◽  
Prognostic Index ◽  
Advanced Cancer Patients ◽  
Hospice Nurses ◽  
Home Based ◽  
Palliative Prognostic Index ◽  
The Difference ◽  
Group B

Background: The simplified Palliative Prognostic Index (sPPI) substitutes a single item from the Communication Capacity Scale (CCS) for the delirium item of the original PPI. This study aimed to examine the validity of the sPPI for patients with advanced cancer in a home-based hospice care setting.Methods: This study included 75 patients with advanced cancer who received home-based hospice care. We used medical records maintained by professional hospice nurses who had visited the patients in their homes. Based on their sPPI score, patients were divided into three groups—A (<4), B (≥4 and <6), and C (≥6)—to compare survival. Further, we investigated the sPPI’s accuracy using the area under the receiver operating characteristic curve (AUC) and sensitivity and specificity for 3- and 6-week survival. We used three sPPIs including different substitutions for the delirium item (two methods using the CCS and one using the Korean Nursing Delirium Screening Scale).Results: The median survival was 60–61 days for group A, 27–30 days for group B, and 12–16 days for group C. The difference in survival was significant (P<0.05). The AUC was 0.814–0.867 for 3-week survival and 0.736–0.779 for 6-week survival. For 3- and 6-week survival, prognostic prediction showed sensitivities of 76.2%–90.9% and 76.3%–86.8%, and specificities of 64.2%–88.7% and 51.4%–70.3%, respectively.Conclusion: The sPPI, which is measured by professional hospice nurses, has acceptable validity to predict survival for patients with advanced cancer in a home hospice setting in South Korea.

scholarly journals Palliative Care and COVID-19 Pandemic: Retrospective Study of Factors Associated With Infection and Death at an Oncological Palliative Care Reference Center

2021 ◽  
pp. 104990912098696
Author(s):  
Livia Costa de Oliveira ◽  
Karla Santos da Costa Rosa ◽  
Ana Luísa Durante ◽  
Luciana de Oliveira Ramadas Rodrigues ◽  
Daianny Arrais de Oliveira da Cunha ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Tumor Type ◽  
Advanced Cancer Patients ◽  
Factors Associated ◽  
Reactive Protein

Background: Advanced cancer patients are part of a group likely to be more susceptible to COVID-19. Aims: To describe the profile of advanced cancer inpatients to an exclusive Palliative Care Unit (PCU) with the diagnosis of COVID-19, and to evaluate the factors associated with death in these cases. Design: Retrospective cohort study with data from advanced cancer inpatients to an exclusive PCU, from March to July 2020, with severe acute respiratory syndrome. Diagnostic of COVID-19 and death were the dependent variables. Logistic regression analyses were performed, with the odds ratio (OR) and 95% confidence interval (CI). Results: One hundred fifty-five patients were selected. The mean age was 60.9 (±13.4) years old and the most prevalent tumor type was breast (30.3%). Eighty-three (53.5%) patients had a diagnostic confirmation of COVID-19. Having diabetes mellitus (OR: 2.2; 95% CI: 1.1-6.6) and having received chemotherapy in less than 30 days before admission (OR: 3.8; 95% CI: 1.2-12.2) were associated factors to diagnosis of COVID-19. Among those infected, 81.9% died and, patients with Karnofsky Performance Status (KPS) < 30% (OR: 14.8; 95% CI 2.7-21.6) and C-reactive protein (CRP) >21.6mg/L (OR: 9.3; 95% CI 1.1-27.8), had a greater chance of achieving this outcome. Conclusion: Advanced cancer patients who underwent chemotherapy in less than 30 days before admission and who had diabetes mellitus were more likely to develop Coronavirus 2019 disease. Among the confirmed cases, those hospitalized with worse KPS and bigger CRP were more likely to die.

scholarly journals Association of the Lung Immune Prognostic Index with Immunotherapy Outcomes in Mismatch Repair Deficient Tumors

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3776
Author(s):  
Edouard Auclin ◽  
Perrine Vuagnat ◽  
Cristina Smolenschi ◽  
Julien Taieb ◽  
Jorge Adeva ◽  
...  
Keyword(s):  
Checkpoint Inhibitors ◽  
Performance Status ◽  
Prognostic Index ◽  
Predictive Marker ◽  
Risk Groups ◽  
Two Factors ◽  
One Year ◽  
Metastatic Sites ◽  
Tumor Types

Background: MSI-H/dMMR is considered the first predictive marker of efficacy for immune checkpoint inhibitors (ICIs). However, around 39% of cases are refractory and additional biomarkers are needed. We explored the prognostic value of pretreatment LIPI in MSI-H/dMMR patients treated with ICIs, including identification of fast-progressors. Methods: A multicenter retrospective study of patients with metastatic MSI-H/dMMR tumors treated with ICIs between April 2014 and May 2019 was performed. LIPI was calculated based on dNLR > 3 and LDH > upper limit of normal. LIPI groups were good (zero factors), intermediate (one factor) and poor (two factors). The primary endpoint was overall survival (OS), including the fast-progressor rate (OS < 3 months). Results: A total of 151 patients were analyzed, mainly female (59%), with median age 64 years, performance status (PS) 0 (42%), and sporadic dMMR status (68%). ICIs were administered as first or second-line for 59%. The most frequent tumor types were gastrointestinal (66%) and gynecologic (22%). LIPI groups were good (47%), intermediate (43%), and poor (10%). The median follow-up was 32 months. One-year OS rates were 81.0%, 67.1%, and 21.4% for good, intermediate, and poor-risk groups (p <0.0001). After adjustment for tumor site, metastatic sites and PS, LIPI remained independently associated with OS (HR, poor-LIPI: 3.50, 95%CI: 1.46–8.40, p = 0.02. Overall, the fast-progressor rate was 16.0%, and 35.7% with poor-LIPI vs. 7.5% in the good-LIPI group (p = 0.02). Conclusions: LIPI identifies dMMR patients who do not benefit from ICI treatment, particularly fast-progressors. LIPI should be included as a stratification factor for future trials.

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