Survival prediction and frequency of anticancer treatment in cancer patients hospitalized due to acute conditions. Role of clinical parameters and PaP score

Abstract

Although the PaP score accurately predicts life expectancy, its use in the setting of acute conditions seems not straightforward, due to the overall good prognosis of these patients. Active treatment in the last period of life is common. The potential reversibility of acute conditions makes prognostic measures inadequate for the purpose of treatment choices.

A prospective, multicenter cohort study to validate a simple performance status–based survival prediction system for oncologists

“…27,28 Our study has many strengths, including its multicenter, prospective design with 2426 patients, the inclusion of patients receiving anticancer therapy, and a systemic and comprehensive assessment of the prognostic value. Accurate survival prediction assists oncologists in making decisions and may prevent unnecessary cancer treatments.…”

Use of targeted therapy in cancer patients in the end-of-life period: results from an Australian centre

“…There is some data to suggest parameters that can help with prognostication. The PaP model (incorporating biochemical information and physician's survival predictions) was useful for predicting survival in those with good performance status [19]. Despite the use of such models, physicians still have difficulty; in the study by Christakis et al, only 20 % of physicians prognosticated correctly and 63 % overestimated survival.…”

A score to identify patients with metastatic spinal cord compression who may be candidates for best supportive care

“…Our new scoring system has been designed for patients referred for palliative treatment, whereas the PaP was designed for patients who received palliative care alone. The finding that the PaP is not appropriate for patients receiving active anticancer treatment has been recently suggested in a series of 208 patients with a median survival of 19 weeks who had been admitted to a department of medical oncology and radiotherapy in Italy 16…”