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Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study

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Abstract

Goals of work

The goal of this study was to develop a new, objective prognostic score (OPS) for terminally ill cancer patients based on an integrated model that includes novel objective prognostic factors.

Materials and methods

A multicenter study of 209 terminally ill cancer patients from six training hospitals in Korea were prospectively followed until death. The Cox proportional hazard model was used to adjust for the influence of clinical and laboratory variables on survival time. The OPS was calculated from the sum of partial scores obtained from seven significant predictors determined by the final model. The partial score was based on the hazard ratio of each predictor. The accuracy of the OPS was evaluated.

Main results

The overall median survival was 26 days. On the multivariate analysis, reduced oral intake, resting dyspnea, low performance status, leukocytosis, elevated bilirubin, elevated creatinine, and elevated lactate dehydrogenase (LDH) were identified as poor prognostic factors. The range of OPS was from 0.0 to 7.0. For the above cutoff point of 3.0, the 3-week prediction sensitivity was 74.7%, the specificity was 76.5%, and the overall accuracy was 75.5%.

Conclusions

We developed the new OPS, without clinician’s survival estimates but including a new prognostic factor (LDH). This new instrument demonstrated accurate prediction of the 3-week survival. The OPS had acceptable accuracy in this study population (training set). Further validation is required on an independent population (testing set).

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Acknowledgement

This study was supported by a grant from the 2006 Support Fund for Research Group of Korean Academy of Family Physicians. The study sponsors had no role in this study.

Conflict of interest statement

None.

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Authors and Affiliations

  1. Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, South Korea

    Sang-Yeon Suh

  2. Department of Family Medicine, Korea University Guro Hospital, 80 Guro-dong, Guro-gu, Seoul, South Korea

    Youn Seon Choi & Daegyeun Kim

  3. Department of Family Medicine, Yongdong Severance Hospital, Yonsei University Health System, Seoul, South Korea

    Jae Yong Shim

  4. Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang-si, Gyeonggi-do, South Korea

    Young Sung Kim

  5. Department of Palliative Medicine, Kangnam St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Chang Hwan Yeom

  6. Department of Palliative Medicine, St. Paul’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Daeyoung Kim

  7. Department of Family Medicine, Seobuk Hospital, Seoul Metropolitan Government, Seoul, South Korea

    Shin Ae Park, Sooa Kim & Ji Yeon Seo

  8. Department of Family Medicine, Korea University Ansan Hospital, Goyang-si, Gyeonggi-do, South Korea

    Su Hyun Kim

  9. Department of Laboratory Medicine, College of Medicine and Asan Medical Center, University of Ulsan, Seoul, South Korea

    Sung-Eun Choi

  10. Department of Statistics, Dongguk University, Seoul, South Korea

    Hong-Yup Ahn

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  1. Sang-Yeon Suh
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  2. Youn Seon Choi
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  4. Young Sung Kim
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  9. Ji Yeon Seo
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  10. Su Hyun Kim
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  11. Daegyeun Kim
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  13. Hong-Yup Ahn
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Corresponding author

Correspondence to Youn Seon Choi.

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Suh, SY., Choi, Y.S., Shim, J.Y. et al. Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study. Support Care Cancer 18, 151–157 (2010). https://doi.org/10.1007/s00520-009-0639-x

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  • DOI: https://doi.org/10.1007/s00520-009-0639-x

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