A combination of routine laboratory findings and vital signs can predict survival of advanced cancer patients without physician evaluation: a fractional polynomial model
A combination of routine laboratory findings and vital signs can predict survival of advanced cancer patients without physician evaluation: a fractional polynomial model
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DOI：
10.1016/j.ejca.2018.09.037
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发表时间：
2018-12-01
影响因子：
8.4
通讯作者：
Morita, Tatsuya
中科院分区：
文献类型：
--
作者：
Hamano, Jun;Takeuchi, Ayano;Morita, Tatsuya
前言：目前还没有关于完全用客观变量预测晚期癌症患者生存率的报道。我们的目的是开发一个预后模型的基础上，实验室检查结果和生命体征使用分数多项式（FP）model.Methods：一个多中心的前瞻性队列研究进行了58个专科姑息治疗服务在日本从2012年9月至2014年4月。符合条件的患者年龄超过20岁，患有晚期癌症。我们开发的模型预测7天，14天，30天，56天和90天的生存期，通过使用FP modeling method.Results：数据分析1039例患者，以开发每个预后模型（晚期癌症的客观预后指数[OPI-AC]）。所有模型均包括心率、尿素和白蛋白，部分模型包括呼吸频率、肌酐、C反应蛋白、淋巴细胞计数、中性粒细胞计数、总胆红素、乳酸脱氢酶和血小板/淋巴细胞比值。7天、14天、30天、56天和90天模型的曲线下面积分别为0.77、0.81、0.90、0.90和0.92。OPI-AC预测30天、56天和90天生存率的准确性显著高于姑息预后评分或姑息治疗研究模型中的预后，后者基于症状和医生估计的组合。我们开发了高度准确的预后指标，仅从客观变量预测晚期癌症患者的生存率，这对于寿命终止管理可能是有用的。FP建模方法可能是有前途的发展在未来的研究中的其他预测模型。(C)2018爱思唯尔有限公司版权所有
Introduction: There have been no reports about predicting survival of patients with advanced cancer constructed entirely with objective variables. We aimed to develop a prognostic model based on laboratory findings and vital signs using a fractional polynomial (FP) model.Methods: A multicentre prospective cohort study was conducted at 58 specialist palliative care services in Japan from September 2012 to April 2014. Eligible patients were older than 20 years and had advanced cancer. We developed models for predicting 7-day, 14-day, 30-day, 56-day and 90-day survival by using the FP modelling method.Results: Data from 1039 patients were analysed to develop each prognostic model (Objective Prognostic Index for advanced cancer [OPI-AC]). All models included the heart rate, urea and albumin, while some models included the respiratory rate, creatinine, C-reactive protein, lymphocyte count, neutrophil count, total bilirubin, lactate dehydrogenase and platelet/lymphocyte ratio. The area under the curve was 0.77, 0.81, 0.90, 0.90 and 0.92 for the 7-day, 14-day, 30-day, 56-day and 90-day model, respectively. The accuracy of the OPI-AC predicting 30-day, 56-day and 90-day survival was significantly higher than that of the Palliative Prognostic Score or the Prognosis in Palliative Care Study model, which are based on a combination of symptoms and physician estimation.Conclusion: We developed highly accurate prognostic indexes for predicting the survival of patients with advanced cancer from objective variables alone, which may be useful for end-of-life management. The FP modelling method could be promising for developing other prognostic models in future research. (C) 2018 Elsevier Ltd. All rights reserved.