Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral

Background: Timely palliative transition in patients with advanced cancer is essential for their improved quality of life and overall survival (OS). Most prognostic models have been developed focusing on weeks’ survival. The current study aimed to compare the accuracies of several indicators, such a...

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Main Authors: Eun Hee Jung, Yusuke Hiratsuka, Sang-Yeon Suh, Seok-Joon Yoon, Beodeul Kang, Si Won Lee, Koung Jin Suh, Ji-Won Kim, Se Hyun Kim, Jin Won Kim, Keun-Wook Lee, Yu Jung Kim
Format: Article
Language:English
Published: Mary Ann Liebert 2024-10-01
Series:Palliative Medicine Reports
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Online Access:https://www.liebertpub.com/doi/10.1089/pmr.2024.0013
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author Eun Hee Jung
Yusuke Hiratsuka
Sang-Yeon Suh
Seok-Joon Yoon
Beodeul Kang
Si Won Lee
Koung Jin Suh
Ji-Won Kim
Se Hyun Kim
Jin Won Kim
Keun-Wook Lee
Yu Jung Kim
author_facet Eun Hee Jung
Yusuke Hiratsuka
Sang-Yeon Suh
Seok-Joon Yoon
Beodeul Kang
Si Won Lee
Koung Jin Suh
Ji-Won Kim
Se Hyun Kim
Jin Won Kim
Keun-Wook Lee
Yu Jung Kim
author_sort Eun Hee Jung
collection DOAJ
description Background: Timely palliative transition in patients with advanced cancer is essential for their improved quality of life and overall survival (OS). Most prognostic models have been developed focusing on weeks’ survival. The current study aimed to compare the accuracies of several indicators, such as the Karnofsky Performance Scale (KPS), Clinicians’ Prediction of Survival (CPS), and Edmonton Symptom Assessment System (ESAS), for predicting the survival of patients. Methods: Two hundred patients were enrolled at a single tertiary cancer center in South Korea between 2016 and 2019. We compared the discrimination of CPS versus KPS and ESAS total scores using the area under the receiver operating characteristic curve (AUROC) in 3-month and 6-month survival predictions. Results: The median age of patients was 66.0 years, and 128 (64%) were male. Two-thirds (66%) of the patients had an Eastern Cooperative Oncology Group performance status of 0 or 1, and 55.5% had a KPS of 80% or higher. The values of AUROC of CPS, KPS, and ESAS total score in 3-month survival prediction were 0.80 (95% confidence interval [CI]: 0.73–0.88), 0.71 (95% CI: 0.62–0.79), and 0.71 (95% CI: 0.62–0.81), respectively, whereas those in 6-month survival were 0.82 (95% CI: 0.76–0.88), 0.70 (95% CI: 0.63–0.78), and 0.63 (95% CI: 0.55–0.71), respectively. Conclusion: CPS showed the highest accuracy in predicting 3- and 6-month survival, whereas KPS had an acceptable accuracy. Experienced clinicians can rely on CPS to predict survival in months. We recommend the use of KPS with CPS to assist inexperienced clinicians.
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series Palliative Medicine Reports
spelling doaj-art-2b11949bf4df41c2bc5f6f5603ccfa7d2025-08-20T03:49:37ZengMary Ann LiebertPalliative Medicine Reports2689-28202024-10-015136537210.1089/pmr.2024.0013Clinicians’ Prediction of Survival Is Most Useful for Palliative Care ReferralEun Hee Jung0Yusuke Hiratsuka1Sang-Yeon Suh2Seok-Joon Yoon3Beodeul Kang4Si Won Lee5Koung Jin Suh6Ji-Won Kim7Se Hyun Kim8Jin Won Kim9Keun-Wook Lee10Yu Jung Kim11Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Department of Palliative Medicine, Takeda General Hospital, Aizu Wakamatsu, Japan.Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang-si, South Korea.Department of Family Medicine, Chungnam National University Hospital, Daejeon, South Korea.Division of Medical Oncology, Bundang Medical Center, CHA University, Seongnam-si, South Korea.Palliative Care Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Background: Timely palliative transition in patients with advanced cancer is essential for their improved quality of life and overall survival (OS). Most prognostic models have been developed focusing on weeks’ survival. The current study aimed to compare the accuracies of several indicators, such as the Karnofsky Performance Scale (KPS), Clinicians’ Prediction of Survival (CPS), and Edmonton Symptom Assessment System (ESAS), for predicting the survival of patients. Methods: Two hundred patients were enrolled at a single tertiary cancer center in South Korea between 2016 and 2019. We compared the discrimination of CPS versus KPS and ESAS total scores using the area under the receiver operating characteristic curve (AUROC) in 3-month and 6-month survival predictions. Results: The median age of patients was 66.0 years, and 128 (64%) were male. Two-thirds (66%) of the patients had an Eastern Cooperative Oncology Group performance status of 0 or 1, and 55.5% had a KPS of 80% or higher. The values of AUROC of CPS, KPS, and ESAS total score in 3-month survival prediction were 0.80 (95% confidence interval [CI]: 0.73–0.88), 0.71 (95% CI: 0.62–0.79), and 0.71 (95% CI: 0.62–0.81), respectively, whereas those in 6-month survival were 0.82 (95% CI: 0.76–0.88), 0.70 (95% CI: 0.63–0.78), and 0.63 (95% CI: 0.55–0.71), respectively. Conclusion: CPS showed the highest accuracy in predicting 3- and 6-month survival, whereas KPS had an acceptable accuracy. Experienced clinicians can rely on CPS to predict survival in months. We recommend the use of KPS with CPS to assist inexperienced clinicians.https://www.liebertpub.com/doi/10.1089/pmr.2024.0013advanced cancerpalliative carepredictionsurvival
spellingShingle Eun Hee Jung
Yusuke Hiratsuka
Sang-Yeon Suh
Seok-Joon Yoon
Beodeul Kang
Si Won Lee
Koung Jin Suh
Ji-Won Kim
Se Hyun Kim
Jin Won Kim
Keun-Wook Lee
Yu Jung Kim
Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral
Palliative Medicine Reports
advanced cancer
palliative care
prediction
survival
title Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral
title_full Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral
title_fullStr Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral
title_full_unstemmed Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral
title_short Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral
title_sort clinicians prediction of survival is most useful for palliative care referral
topic advanced cancer
palliative care
prediction
survival
url https://www.liebertpub.com/doi/10.1089/pmr.2024.0013
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