Abstract:PURPOSE Uncertainty of prognosis is one reason patients with hematologic malignancies receive aggressive therapy near end of life more often than those with advanced solid tumors. It is unknown whether end-of-life prognosis prediction models are useful for patients with hematologic malignancies, especially hospitalized patients receiving chemotherapy, because most prognostic models were developed for patients with solid tumors. The purpose of this study was to evaluate the prognostic accuracy of the Palliative… Show more
“…The median OS of the patients was 72 days (95% CI, 45-96) in group A, 39 days (95% CI, 30-45) in group B, and 13 days (95% CI, 10-16) in group C. Statistically significant differences were observed between all groups ( P < .05), and this result was similar to that of our previous study. 2 When a PPI of more than 6 was adopted as a cut-off point, 3-week survival was predicted with a sensitivity of 69.4%, specificity of 86.5%, PPV of 80.4%, NPV of 74.2%, and overall accuracy of 76.5%. When a PPI of less than 4 was used as a cut-off point, 6-week survival was predicted with a sensitivity of 76.3%, specificity of 71.3%, PPV of 54.2%, NPV of 87.1%, and overall accuracy of 72.9%.Figure 1.Kaplan–Meier overall survival curves of groups with different scores on the (A) Palliative Prognostic Index (PPI) in overall patients; (B) Glasgow Prognostic Score (GPS) in overall patients; (C) PPI in patients who received chemotherapy (n = 82); (D) GPS in patients who received chemotherapy.…”
Section: Resultsmentioning
confidence: 98%
“…These results corroborate our findings in our previous study. 2 Patient characteristics and the comparison between the received chemotherapy group (n = 82) and the non-received chemotherapy group (n = 165) are summarized in Table 1. The mean age was significantly lower in patients who received chemotherapy (68.8 years) than in those who did not receive chemotherapy (75.3 years; P < .001).…”
Section: Patient Characteristicsmentioning
confidence: 99%
“…In a previous study, 2 we validated the application of the Palliative Prognostic Index (PPI) 3 for patients with end-of-life hematological malignancies who died at a university hospital. PPI is one of the most widely used end-of-life prognosis prediction models, mainly for patients with solid tumors.…”
Background Clinicians can appropriately terminate treatment or reduce treatment intensity by determining prognostic factors of end-of-life chemotherapy. In particular, it provides important information for patients with hematological malignancies who receive chemotherapy until near-the-end of life compared with patients with solid tumors. This study aimed to clarify whether existing prognostic tools are associated with the survival in patients with end-of-life hematological malignancies who received chemotherapy. Methods We retrospectively reviewed the records of 247 patients diagnosed with hematological malignancies and died at our university hospital hematology ward between May 2015 and May 2021. We performed multivariate analysis in 82 (33.2%) patients who received end-of-life chemotherapy using the Palliative Prognostic Index (PPI) and inflammation-based prognostic models, such as the Glasgow Prognostic Score (GPS), Prognostic Nutritional Index (PNI), and Controlling Nutrition Status (CONUT). Results On comparing 82 patients who received end-of-life chemotherapy with 165 patients who did not, the proportion of patients with PPI group A, GPS score = 0, and CONUT normal/mild was significantly higher among patients who received chemotherapy. In multivariate analysis, we identified PPI groups B (2.0 < PPI ≤ 4.0) and C (PPI > 4.0) [hazard ratio (HR) 2.1290, 95% CI 1.1830-3.828, P = .01166, respectively] and age ≥ 65 years (HR 2.0170, 95% CI 1.1280-3.607, P = .01805) were associated with overall survival. Conclusion PPI use and age were independent associating factors for patients with hematological malignancies receiving end-of-life chemotherapy. PPI, a popular prognostic tool may be helpful for patients and hematologists to make decisions about end-of-life care.
“…The median OS of the patients was 72 days (95% CI, 45-96) in group A, 39 days (95% CI, 30-45) in group B, and 13 days (95% CI, 10-16) in group C. Statistically significant differences were observed between all groups ( P < .05), and this result was similar to that of our previous study. 2 When a PPI of more than 6 was adopted as a cut-off point, 3-week survival was predicted with a sensitivity of 69.4%, specificity of 86.5%, PPV of 80.4%, NPV of 74.2%, and overall accuracy of 76.5%. When a PPI of less than 4 was used as a cut-off point, 6-week survival was predicted with a sensitivity of 76.3%, specificity of 71.3%, PPV of 54.2%, NPV of 87.1%, and overall accuracy of 72.9%.Figure 1.Kaplan–Meier overall survival curves of groups with different scores on the (A) Palliative Prognostic Index (PPI) in overall patients; (B) Glasgow Prognostic Score (GPS) in overall patients; (C) PPI in patients who received chemotherapy (n = 82); (D) GPS in patients who received chemotherapy.…”
Section: Resultsmentioning
confidence: 98%
“…These results corroborate our findings in our previous study. 2 Patient characteristics and the comparison between the received chemotherapy group (n = 82) and the non-received chemotherapy group (n = 165) are summarized in Table 1. The mean age was significantly lower in patients who received chemotherapy (68.8 years) than in those who did not receive chemotherapy (75.3 years; P < .001).…”
Section: Patient Characteristicsmentioning
confidence: 99%
“…In a previous study, 2 we validated the application of the Palliative Prognostic Index (PPI) 3 for patients with end-of-life hematological malignancies who died at a university hospital. PPI is one of the most widely used end-of-life prognosis prediction models, mainly for patients with solid tumors.…”
Background Clinicians can appropriately terminate treatment or reduce treatment intensity by determining prognostic factors of end-of-life chemotherapy. In particular, it provides important information for patients with hematological malignancies who receive chemotherapy until near-the-end of life compared with patients with solid tumors. This study aimed to clarify whether existing prognostic tools are associated with the survival in patients with end-of-life hematological malignancies who received chemotherapy. Methods We retrospectively reviewed the records of 247 patients diagnosed with hematological malignancies and died at our university hospital hematology ward between May 2015 and May 2021. We performed multivariate analysis in 82 (33.2%) patients who received end-of-life chemotherapy using the Palliative Prognostic Index (PPI) and inflammation-based prognostic models, such as the Glasgow Prognostic Score (GPS), Prognostic Nutritional Index (PNI), and Controlling Nutrition Status (CONUT). Results On comparing 82 patients who received end-of-life chemotherapy with 165 patients who did not, the proportion of patients with PPI group A, GPS score = 0, and CONUT normal/mild was significantly higher among patients who received chemotherapy. In multivariate analysis, we identified PPI groups B (2.0 < PPI ≤ 4.0) and C (PPI > 4.0) [hazard ratio (HR) 2.1290, 95% CI 1.1830-3.828, P = .01166, respectively] and age ≥ 65 years (HR 2.0170, 95% CI 1.1280-3.607, P = .01805) were associated with overall survival. Conclusion PPI use and age were independent associating factors for patients with hematological malignancies receiving end-of-life chemotherapy. PPI, a popular prognostic tool may be helpful for patients and hematologists to make decisions about end-of-life care.
“…Performance status (PS), oral intake, dyspnea, and delirium have been reported as prognostic factors that do not require blood testing [15,16]. Validated prognostic tools that do not require blood tests include Palliative Prognostic Index (PPI) [17][18][19][20][21], and Performance Status-Based Palliative Prognostic Index (PS-PPI) [22]. The PPI is calculated by PS based on the Palliative Performance Scale (PPS) [23], oral intake, edema, dyspnea at rest, and delirium.…”
Predicting the short-term prognosis of patients with terminal cancer is important for treatment decisions and improving patients’ quality of life. Recently, it has been reported that the Barthel Index (BI) can predict short-term prognosis. This study aimed to distinguish the BI items that can more accurately predict the short-term prognosis of terminal cancer patients from among the other BI items. This study compared the accuracy of predicting the 1-, 2-, and 3-week prognosis of BI and individual BI items in 158 cancer patients who died between January 2018 and June 2020 at the Onomichi Municipal Hospital in Japan. For predicting the 1- and 2-week prognosis, the BI item “feeding” scores of 0/5 and 10 showed higher accuracies (0.766 and 0.715, respectively) than BI scores between 0–15 and 20–100. For predicting a 3-week prognosis, the BI item “mobility” scores of 0, 5/10, 15 and the BI item “grooming” scores between 0–5 showed higher accuracies (0.627 and 0.614, respectively) than BI scores between 0–35 and 40–100. BI and individual BI items may be an option for prognostic prediction in terminal cancer patients.
“…Data as to the impact of targeted and cellular treatments on quality of life and EOL outcomes are beginning to be reported (13). In addition, new prognostic tools which are being developed and validated for use in HM may assist patients and clinicians to reach shared decisions better reflecting patient values and needs (14,15). Future studies should also take into consideration the variety of HM as well as the varying trajectories of these diseases.…”
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