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KMID : 0939920220540020621
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대한암학회지
2022 Volume.54 No. 2 p.621 ~ p.629
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A Prognostic Model to Facilitate Palliative Care Referral in Oncology Outpatients
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Kim Yu-Jung
Hiratsuka Yusuke
Suh Sang-Yeon
Kang Beo-Deul
Lee Si-Won
Ahn Hong-Yup
Suh Koung-Jin
Kim Ji-Won
Kim Se-Hyun
Kim Jin-Won
Lee Keun-Wook
Kim Jee-Hyun
Lee Jong-Seok
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Abstract
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Purpose: We aimed to develop a prognostic model to assist palliative care referral at least 3 months before death in advanced cancer patients treated at an outpatient medical oncology clinic.
Materials and Methods: In this prospective cohort study, a total of 200 patients were enrolled at a tertiary cancer center in South Korea. The major eligibility criterion was an expected survival of less than a year as estimated by their oncologists. We analyzed the influences of known prognostic factors along with chemotherapy status, mid-arm circumference, and triceps skinfold thickness on survival time.
Results: The mean age of the patients was 64.5 years, 36% were female, and the median survival time was 7.6 months. In the multivariate analysis, we found six significant factors related to poor survival: a poor Eastern Cooperative Oncology Group (ECOG) performance status (≥ 2), not undergoing chemotherapy, anorexia, a low lymphocyte level (< 12%), a high lactate dehydrogenase (LDH) level (≥ 300 IU/L), and a low mid-arm circumference (< 23 cm). We developed a prognostic model (score, 0?8.0) to predict 3-month survival based on the multivariate analysis. Patients who scored ≥ 4.0 points had a short survival of less than 3 months (p < 0.001). The discriminating ability of the prognostic model using the area under the receiver operating characteristic curve was 0.88.
Conclusion: The prognostic model using ECOG performance status, chemotherapy status, anorexia, lymphocytes, LDH, and mid-arm circumference can predict 3-month survival in medical oncology outpatients. It can alert oncologists to refer patients to palliative care specialists before it is too late.
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KEYWORD
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Neoplasms, Prognosis, Survival, Palliative care
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