Prognostic model for patients with advanced cancer using a combination of routine blood test values
- 14 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Supportive Care in Cancer
- Vol. 29 (8), 4431-4437
- https://doi.org/10.1007/s00520-020-05937-5
Abstract
Purpose The purpose of this study was to develop a simple prognostic model based on objective indicators alone, i.e., routine blood test data, without using any subjective variables such as patient’s symptoms and physician’s prediction. Methods The subjects of this retrospective study were patients at the palliative care unit of Tohoku University Hospital, Japan. Eligible patients were over 20 years old and had advanced cancer (n = 225). The model for predicting survival was developed based on Cox proportional hazards regression models for univariable and multivariable analyses of 20 items selected from routine blood test data. All the analyses were performed according to the TRIPOD statement (https://www.tripod-statement.org/). Results The univariable and multivariable regression analyses identified total bilirubin, creatinine, urea/creatinine ratio, aspartate aminotransferase, albumin, total leukocyte count, differential lymphocyte count, and platelet/lymphocyte ratio as significant risk factors for mortality. Based on the hazard ratios, the area under the curve for the new risk model was 0.87 for accuracy, 0.83 for sensitivity, and 0.74 for specificity. Diagnostic accuracy was higher than provided by the Palliative Prognostic Score and the Palliative Prognostic Index. The Kaplan–Meier analysis demonstrated a survival significance of classifying patients according to their score into low-, medium-, and high-mortality risk groups having median survival times of 67 days, 34 days, and 11 days, respectively (p < 0.001). Conclusions We developed a simple and accurate prognostic model for predicting the survival of patients with advanced cancer based on routine blood test values alone that may be useful for appropriate advanced care planning in a palliative care setting.This publication has 23 references indexed in Scilit:
- A combination of routine laboratory findings and vital signs can predict survival of advanced cancer patients without physician evaluation: a fractional polynomial modelEuropean Journal of Cancer, 2018
- Objective Predictive Score as a Feasible Biomarker for Short-term Survival in TerminalIy Ill Patients with CancerAnticancer Research, 2017
- Clinician prediction of survival versus the Palliative Prognostic Score: Which approach is more accurate?European Journal of Cancer, 2016
- Objective Palliative Prognostic Score Among Patients With Advanced CancerJournal of Pain and Symptom Management, 2014
- Development of Prognosis in Palliative care Study (PiPS) predictor models to improve prognostication in advanced cancer: prospective cohort studyBMJ, 2011
- An inflammation-based prognostic score (mGPS) predicts cancer survival independent of tumour site: a Glasgow Inflammation Outcome StudyBritish Journal of Cancer, 2011
- Predicting prognosis in patients with advanced cancerAnnals of Oncology, 2007
- Prognostic Factors in Advanced Cancer Patients: Evidence-Based Clinical Recommendations—A Study by the Steering Committee of the European Association for Palliative CareJournal of Clinical Oncology, 2005
- A systematic review of physicians' survival predictions in terminally ill cancer patientsBMJ, 2003
- The Palliative Prognostic Index: a scoring system for survival prediction of terminally ill cancer patientsSupportive Care in Cancer, 1999