Assessing 2-Month Clinical Prognosis in Hospitalized Patients With Advanced Solid Tumors

Abstract

The prognostic profiles defined by combinations of these four factors may be potentially useful but need further validation before their application in the daily practice.

Optimal indications of surgical palliation for incurable advanced gastric cancer presenting with malignant gastrointestinal obstruction

“…The survivals of terminally ill patients were found to be often overestimated by physicians in a large prospective cohort study [14], and against this background, we consider that prognostic factors are essential for planning optimal end-of-life treatment. In accordance with our findings, poor PS of 2 or more [6,12,[15][16][17], and advanced disease with no prior history of cancer therapy [6] have been reported to correlate with poor prognosis in terminally ill cancer patients. Although the presence of multiple metastatic sites [16] and raised CRP level [17][18][19][20] were reported as valuable prognostic factors both in patients with advanced cancer and in palliative care patients, neither of these factors were prognostically significant in the present study, despite the short survival of the respective cohort.…”

“…In accordance with our findings, poor PS of 2 or more [6,12,[15][16][17], and advanced disease with no prior history of cancer therapy [6] have been reported to correlate with poor prognosis in terminally ill cancer patients. Although the presence of multiple metastatic sites [16] and raised CRP level [17][18][19][20] were reported as valuable prognostic factors both in patients with advanced cancer and in palliative care patients, neither of these factors were prognostically significant in the present study, despite the short survival of the respective cohort. In addition, an association of decreased Alb level with poor prognosis was not demonstrated in this study, partly due to the comparatively well-maintained Alb level (median value of 3.5 g/ dl) in our patients, though this association has been identified in the literature [3,6,13,16,19].…”

“…Although the presence of multiple metastatic sites [16] and raised CRP level [17][18][19][20] were reported as valuable prognostic factors both in patients with advanced cancer and in palliative care patients, neither of these factors were prognostically significant in the present study, despite the short survival of the respective cohort. In addition, an association of decreased Alb level with poor prognosis was not demonstrated in this study, partly due to the comparatively well-maintained Alb level (median value of 3.5 g/ dl) in our patients, though this association has been identified in the literature [3,6,13,16,19]. Even when the cutoff value of Alb was set at 3.0 g/dl or a prognostic nutritional index [PNI; 10 9 Alb (g/dl) ?…”

“…0.005 9 lymphocyte counts (/mm 3 )] of 40 or less was used as an indicator of malnutrition in multivariate analysis, neither nutritional index was prognostically significant (P = 0.5433; hazard ratio = 1.370; 95% CI 0.497-3.779 for Alb, and P = 0.8741; hazard ratio = 0.948; 95% CI 0.490-1.835 for PNI). With respect to BMI, patients maintaining a BMI above normal showed diminished survival in the present study; this could be attributed to several factors, such as the presence of ascites and edema, which has been indicated as a negative prognostic factor [3,12,16]. Because of this unstable characteristic of BMI, it has not been assessed as a prognostic index in palliative care patients [3,6,16,17].…”

Prognosis Prediction Models and their Clinical Utility in Palliative Care

“…Laboratory factors include inlammatory markers (for instance, C-reactive protein (CRP), erythrocyte sedimentation, or neutrophil lymphocyte ratio) [33,34], nutrition markers (for instance, albumin) [35,36], and tumor progression markers (for instance, calcium or lactate dehydrogenase) [37,38].…”