Abstract
Purpose: To offer evidence-based clinical recommendations concerning prognosis in advanced cancer patients. Methods: A Working Group of the Research Network of the European Association for Palliative Care identified clinically significant topics, reviewed the studies, and assigned the level of evidence. A formal meta-analysis was not feasible because of the heterogeneity of published studies and the lack of minimal standards in reporting results. A systematic electronic literature search within the main available medical literature databases was performed for each of the following four areas identified: clinical prediction of survival (CPS), biologic factors, clinical signs and symptoms and psychosocial variables, and prognostic scores. Only studies on patients with advanced cancer and survival ≤ 90 days were included. Results: A total of 38 studies were evaluated. Level A evidence-based recommendations of prognostic correlation could be formulated for CPS (albeit with a series of limitations of which clinicians must be aware) and prognostic scores. Recommendations on the use of other prognostic factors, such as performance status, symptoms associated with cancer anorexia-cachexia syndrome (weight loss, anorexia, dysphagia, and xerostomia), dyspnea, delirium, and some biologic factors (leukocytosis, lymphocytopenia, and C-reactive protein), reached level B. Conclusion: Prognostication of life expectancy is a significant clinical commitment for clinicians involved in oncology and palliative care. More accurate prognostication is feasible and can be achieved by combining clinical experience and evidence from the literature. Using and communicating prognostic information should be part of a multidisciplinary palliative care approach.
| Original language | English |
|---|---|
| Pages (from-to) | 6240-6248 |
| Number of pages | 9 |
| Journal | Journal of Clinical Oncology |
| Volume | 23 |
| Issue number | 25 |
| DOIs | |
| Publication status | Published - 2005 |
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ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Prognostic factors in advanced cancer patients : Evidence-based clinical recommendations - A study by the steering committee of the european association for palliative care. / Maltoni, Marco; Caraceni, Augusto; Brunelli, Cinzia; Broeckaert, Bert; Christakis, Nicholas; Eychmueller, Steffen; Glare, Paul; Nabal, Maria; Vigano, Antonio; Larkin, Philip; De Conno, Franco; Hanks, Geoffrey; Kaasa, Stein.
In: Journal of Clinical Oncology, Vol. 23, No. 25, 2005, p. 6240-6248.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prognostic factors in advanced cancer patients
T2 - Evidence-based clinical recommendations - A study by the steering committee of the european association for palliative care
AU - Maltoni, Marco
AU - Caraceni, Augusto
AU - Brunelli, Cinzia
AU - Broeckaert, Bert
AU - Christakis, Nicholas
AU - Eychmueller, Steffen
AU - Glare, Paul
AU - Nabal, Maria
AU - Vigano, Antonio
AU - Larkin, Philip
AU - De Conno, Franco
AU - Hanks, Geoffrey
AU - Kaasa, Stein
PY - 2005
Y1 - 2005
N2 - Purpose: To offer evidence-based clinical recommendations concerning prognosis in advanced cancer patients. Methods: A Working Group of the Research Network of the European Association for Palliative Care identified clinically significant topics, reviewed the studies, and assigned the level of evidence. A formal meta-analysis was not feasible because of the heterogeneity of published studies and the lack of minimal standards in reporting results. A systematic electronic literature search within the main available medical literature databases was performed for each of the following four areas identified: clinical prediction of survival (CPS), biologic factors, clinical signs and symptoms and psychosocial variables, and prognostic scores. Only studies on patients with advanced cancer and survival ≤ 90 days were included. Results: A total of 38 studies were evaluated. Level A evidence-based recommendations of prognostic correlation could be formulated for CPS (albeit with a series of limitations of which clinicians must be aware) and prognostic scores. Recommendations on the use of other prognostic factors, such as performance status, symptoms associated with cancer anorexia-cachexia syndrome (weight loss, anorexia, dysphagia, and xerostomia), dyspnea, delirium, and some biologic factors (leukocytosis, lymphocytopenia, and C-reactive protein), reached level B. Conclusion: Prognostication of life expectancy is a significant clinical commitment for clinicians involved in oncology and palliative care. More accurate prognostication is feasible and can be achieved by combining clinical experience and evidence from the literature. Using and communicating prognostic information should be part of a multidisciplinary palliative care approach.
AB - Purpose: To offer evidence-based clinical recommendations concerning prognosis in advanced cancer patients. Methods: A Working Group of the Research Network of the European Association for Palliative Care identified clinically significant topics, reviewed the studies, and assigned the level of evidence. A formal meta-analysis was not feasible because of the heterogeneity of published studies and the lack of minimal standards in reporting results. A systematic electronic literature search within the main available medical literature databases was performed for each of the following four areas identified: clinical prediction of survival (CPS), biologic factors, clinical signs and symptoms and psychosocial variables, and prognostic scores. Only studies on patients with advanced cancer and survival ≤ 90 days were included. Results: A total of 38 studies were evaluated. Level A evidence-based recommendations of prognostic correlation could be formulated for CPS (albeit with a series of limitations of which clinicians must be aware) and prognostic scores. Recommendations on the use of other prognostic factors, such as performance status, symptoms associated with cancer anorexia-cachexia syndrome (weight loss, anorexia, dysphagia, and xerostomia), dyspnea, delirium, and some biologic factors (leukocytosis, lymphocytopenia, and C-reactive protein), reached level B. Conclusion: Prognostication of life expectancy is a significant clinical commitment for clinicians involved in oncology and palliative care. More accurate prognostication is feasible and can be achieved by combining clinical experience and evidence from the literature. Using and communicating prognostic information should be part of a multidisciplinary palliative care approach.
UR - http://www.scopus.com/inward/record.url?scp=24944442592&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=24944442592&partnerID=8YFLogxK
U2 - 10.1200/JCO.2005.06.866
DO - 10.1200/JCO.2005.06.866
M3 - Article
C2 - 16135490
AN - SCOPUS:24944442592
VL - 23
SP - 6240
EP - 6248
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 25
ER -