A Retrospective Study to Explore Prognostic Factors of Short Survival in Patients with Malignant Pleural Mesothelioma upon the Time of Admission to Palliative Care Unit

Objective: This study investigated prognostic factors of short survival in patients with malignant pleural mesothelioma (MPM) upon the time of their admission to the Palliative Care Unit (PCU). Method: We conducted a retrospective review of the medical records of 12 patients with MPM, who died at the PCU of our hospital from January 2016 to April 2018. According to the classification of survival period by previous predictor model, these patients were classified into three Groups, Group A: less than 13 days, Group B: between 14 and 55 days, and Group C: more than 56 days. Results: The number of patients was 5 in Group A, 5 in Group B, and 2 in Group C, respectively. Hemoptysis was seen in 40% of patients of Group A only and oxygen inhalation was necessary for all the patients of Group A. Dysphagia and bilateral pleural involvement were seen in 80% of Group A and in 60% of Group B. Pneumonia was seen in 60% of Group A and in 20% of Group B. The above four factors were not seen in Group C. Conclusion: This preliminary study suggests that hemoptysis, dysphagia, bilateral pleural involvement, pneumonia, and oxygen inhalation are possibly prognostic factors of short survival of patients with MPM upon their admission to PCU.

Validity and Usefulness of Applying Palliative Prognostic Score to Patients with Terminally Ill Hematological Malignancies

Introduction: Among various predicting tools of survival developed for terminally ill cancer patients, Palliative Prognostic Score (PaP) is used very frequently. The target diseases of PaP are solid malignancies other than renal cancer; thus hematological malignancies are not included in them. Objective: To demonstrate that it is appropriate and useful to apply PaP to patients with terminally ill hematological malignancies. Methods: We used PaP to predict the survival of 18 patients with terminally ill hematological malignancies hospitalized in our hospice ward and compared the prediction accuracy with that of the previous studies. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 21-day survival probability were 91.7%, 83.3%, 91.7%, 83.3%, and 88.9%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 30-day survival probability were 72.7%, 85.7%, 88.9%, 66.7%, and 77.8%, respectively. Conclusion: Our results suggest that it may be possible to apply PaP to patients with terminally ill hematological malignancies.