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A Prognostic Model to Facilitate Palliative Care Referral in Oncology Outpatients

Authors
 Yu Jung Kim  ;  Yusuke Hiratsuka  ;  Sang-Yeon Suh  ;  Beodeul Kang  ;  Si Won Lee  ;  Hong-Yup Ahn  ;  Koung Jin Suh  ;  Ji-Won Kim  ;  Se Hyun Kim  ;  Jin Won Kim  ;  Keun-Wook Lee  ;  Jee Hyun Kim  ;  Jong Seok Lee 
Citation
 CANCER RESEARCH AND TREATMENT, Vol.54(2) : 621-629, 2022-04 
Journal Title
CANCER RESEARCH AND TREATMENT
ISSN
 1598-2998 
Issue Date
2022-04
MeSH
Anorexia ; Female ; Humans ; Male ; Medical Oncology ; Middle Aged ; Outpatients* ; Palliative Care* ; Prognosis ; Prospective Studies ; Referral and Consultation ; Retrospective Studies
Keywords
Neoplasms ; Palliative care ; Prognosis ; Survival
Abstract
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 6 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 (AUC) 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.
Files in This Item:
T9992022981.pdf Download
DOI
10.4143/crt.2021.483
Appears in Collections:
6. Others (기타) > Others (기타) > 1. Journal Papers
Yonsei Authors
Lee, Si Won(이시원) ORCID logo https://orcid.org/0000-0002-2144-4298
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/194323
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