• The oncologist · Jan 2012

    Multicenter Study Clinical Trial

    Prospective comparison of prognostic scores in palliative care cancer populations.

    • Marco Maltoni, Emanuela Scarpi, Cristina Pittureri, Francesca Martini, Luigi Montanari, Elena Amaducci, Stefania Derni, Laura Fabbri, Marta Rosati, Dino Amadori, and Oriana Nanni.
    • Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Via P. Maroncelli 40, 47014 Meldola (FC), Italy. ma.maltoni@ausl.fo.it
    • Oncologist. 2012 Jan 1;17(3):446-54.

    PurposePredicting prognosis in advanced cancer aids physicians in clinical decision making and can help patients and their families to prepare for the time ahead.Materials And MethodsThis multicenter, observational, prospective, nonrandomized population-based study evaluated life span prediction of four prognostic scores used in palliative care: the original palliative prognostic score (PaP Score), a variant of PaP Score including delirium (D-PaP Score), the Palliative Performance Scale, and the Palliative Prognostic Index.ResultsA total of 549 patients were enrolled onto the study. Median survival of the entire group was 22 days (95% confidence intervals [95% CI] = 19-24). All four prognostic models discriminated well between groups of patients with different survival probabilities. Log-rank tests were all highly significant (p < .0001). The PaP and D-PaP scores were the most accurate, with a C index of 0.72 (95% CI = 0.70-0.73) and 0.73 (95% CI = 0.71-0.74), respectively.ConclusionIt can be confirmed that all four prognostic scores used in palliative care studies accurately identify classes of patients with different survival probabilities. The PaP Score has been extensively validated and shows high accuracy and reproducibility in different settings.

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