Survival prediction and frequency of anticancer treatment in cancer patients hospitalized due to acute conditions. Role of clinical parameters and PaP score

Gianmauro Numico, Marcella Occelli, Elvio G. Russi, Nicola Silvestris, Raffaella Pasero, Elena Fea, Cristina Granetto, Gianna Di Costanzo, Ida Colantonio, Milena Gasco, Ornella Garrone, Valentina Polla, Marco C. Merlano

Research output: Contribution to journalArticle

Abstract

Purpose Survival prediction is useful in selecting patients for palliative care or active anticancer therapy. The palliative and prognostic (PaP) score was shown to predict 1-month survival in terminally ill patients. Its application to patients with less advanced disease is a subject of debate. We assessed the value of the PaP score and of other clinical parameters in predicting survival in patients admitted in an oncological ward due to acute conditions. We also evaluated the frequency of active anticancer treatment in the last weeks of life. Methods All the 208 patients, consecutively admitted in a department of medical oncology and radiotherapy in a 9-month period, were included. Patients and disease features together with the PaP score were assessed and included in a multivariable model for survival prediction. Results Overall, median survival was 19 weeks and 12-week survival was 59.6%. The PaP score accurately predicted 4-week survival. Among the 39 patients who died within 4 weeks, 36% were on active treatment. The reason of admission, disease control, treatment, and PaP score were independently related to 12-week survival in the multivariate analysis; however patients with a 12-week survival lower than 30% were a minority. Conclusions Although the PaP score accurately predicts life expectancy, its use in the setting of acute conditions seems not straightforward, due to the overall good prognosis of these patients. Active treatment in the last period of life is common. The potential reversibility of acute conditions makes prognostic measures inadequate for the purpose of treatment choices.

Original languageEnglish
Pages (from-to)1823-1830
Number of pages8
JournalSupportive Care in Cancer
Volume19
Issue number11
DOIs
Publication statusPublished - Nov 2011

Keywords

  • Acute condition
  • Chemotherapy
  • PaP score
  • Survival prediction

ASJC Scopus subject areas

  • Oncology

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    Numico, G., Occelli, M., Russi, E. G., Silvestris, N., Pasero, R., Fea, E., Granetto, C., Di Costanzo, G., Colantonio, I., Gasco, M., Garrone, O., Polla, V., & Merlano, M. C. (2011). Survival prediction and frequency of anticancer treatment in cancer patients hospitalized due to acute conditions. Role of clinical parameters and PaP score. Supportive Care in Cancer, 19(11), 1823-1830. https://doi.org/10.1007/s00520-010-1024-5