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Prediction of survival in terminally ill cancer patients at the time of terminal cancer diagnosis

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Abstract

Purpose

We aimed to investigate the prognostic factors that can predict terminal stage survival (TSS) at the time of terminal cancer diagnosis.

Methods

We prospectively evaluated 141 patients immediately after the diagnosis of terminal cancer by their attending oncologists. A total of 32 factors, including performance status, clinical prediction of survival, time to terminal cancer (TTC), clinical symptoms, signs, and laboratory tests including the neutrophil–lymphocyte ratio (NLR), were analyzed. TSS was defined as the time from the diagnosis of terminal cancer to death.

Results

The mean age of the 141 patients studied was 58.7 years, and 53 were female (38 %). The median TSS was 1.7 months (95 % confidence interval [CI] 1.43–1.97). In the univariate analyses, the TSS was significantly associated with 16 of the 32 factors tested. In the multivariate analysis, a lower Karnofsky performance status (KPS), a shorter TTC (<24 months), a high NLR (≥5), and a high C-reactive protein (CRP) level (≥10 mg/dL) were independently associated with a poorer prognosis. A scoring system (scale, 0–6) developed based on the multivariate analysis could be used to classify terminal cancer patients into better (0–2 points; TSS 3.9 months), intermediate (3–4 points; TSS 1.7 months), or worse (5–6 points; TSS 0.9 month, P < 0.001) prognosis.

Conclusion

The median TSS after the diagnosis of terminal cancer in advanced cancer patients was 1.7 months. The scoring system using KPS, TTC, NLR, and CRP could predict TSS in these patients.

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Acknowledgments

We are grateful to Soo Hee Kang and the Medical Research Collaborating Center of Seoul National University Hospital for supporting the statistical analysis of this study. This study was supported by grant number 11-2009-036 from the SNUBH Research Fund, Republic of Korea.

Conflict of interest

We certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.

Author information

Correspondence to Dae Seog Heo.

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Kim, Y.J., Kim, S., Lee, J.K. et al. Prediction of survival in terminally ill cancer patients at the time of terminal cancer diagnosis. J Cancer Res Clin Oncol 140, 1567–1574 (2014). https://doi.org/10.1007/s00432-014-1688-1

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Keywords

  • Terminally ill
  • Terminal cancer
  • Prognosis
  • Prediction
  • Survival