Prospective Comparison of Prognostic Scores in Palliative Care Cancer Populations
Prospective Comparison of Prognostic Scores in Palliative Care Cancer Populations
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DOI：
10.1634/theoncologist.2011-0397
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发表时间：
2012-03-01
期刊：
影响因子：
5.8
通讯作者：
Nanni, Oriana
中科院分区：
文献类型：
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作者：
Maltoni, Marco;Scarpi, Emanuela;Nanni, Oriana
目的.预测晚期癌症的预后有助于医生做出临床决策，并可以帮助患者及其家属为未来的时间做好准备。这项多中心、观察性、前瞻性、非随机人群研究评估了姑息治疗中使用的四种预后评分的寿命预测：原始姑息预后评分（PaP评分）、PaP评分的变体（包括谵妄）（D-PaP评分）、姑息性能量表和姑息预后指数。共有549例患者入组研究。整个组的中位生存期为22天（95%置信区间[95% CI] = 19-24）。所有四个预后模型区分不同生存概率的患者组。对数秩检验均具有高度显著性（p < .0001）。PaP和D-PaP评分的准确性最高，C指数分别为0.72（95%CI = 0.70-0.73）和0.73（95%CI = 0.71-0.74）。可以证实，姑息治疗研究中使用的所有四种预后评分都能准确识别具有不同生存概率的患者类别。PaP评分已经过广泛验证，在不同环境下显示出高准确性和重现性。肿瘤学家2012; 17：446-454
Purpose. Predicting 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 Methods. This 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.Results. A 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.Conclusion. It 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. The Oncologist 2012; 17: 446-454