Identifying prognostic factors for survival in advanced cancer patients: a prospective study.
Hong Kong Med J
; 13(6): 453-9, 2007 Dec.
Article
in En
| MEDLINE
| ID: mdl-18057434
ABSTRACT
OBJECTIVE:
To identify potential prognostic factors affecting the survival in patients with advanced cancer in a local palliative care unit.DESIGN:
Prospective cohort study.SETTING:
Palliative Care Unit of a regional hospital in Hong Kong. PATIENTS All advanced cancer in-patients and out-patients who were enrolled into the palliative care service of the United Christian Hospital between January and December 2002 were recruited. MAIN OUTCOMEMEASURES:
Potential prognostic factors including demographic data, tumour characteristics, blood parameters, functional status, co-morbidities, total symptom score, and psychosocial parameters were recorded upon enrollment.RESULTS:
A total of 170 patients were eligible for analysis; their mean age was 69 (standard deviation, 12) years, of which 106 (62%) were male. Overall median survival was 77 (interquartile range, 31-160) days. The most frequent primary malignancy was lung (n=58, 34%), followed by liver (n= 24, 14%) and lower gastro-intestinal tract (n=24, 14%). By univariate analysis, 11 factors affected survival, including age (P=0.040), number of metastatic sites involved (P=0.001), peritoneal metastases (P=0.009), skin metastases (P=0.011), tachycardia (P=0.009), serum albumin concentration (P<0.001), white cell count (P=0.002), Karnofsky Performance Status score (P<0.001), Hamilton Depression Scale score (P=0.004), Edmonton Symptom Assessment System score (P=0.003), and McGill Quality of Life (Hong Kong)-single item score (P=0.002). Multivariable Cox regression analysis revealed that only age (hazard ratio=0.84; 95% confidence interval, 0.73-0.96), number of metastatic sites involved (1.33; 1.13-1.56), serum albumin concentration (0.95; 0.92-0.98), Karnofsky Performance Status score (0.86; 0.78-0.96), and Edmonton Symptom Assessment System score (1.22; 1.05-1.41) were independent prognosticators.CONCLUSION:
Age, number of involved metastatic sites, serum albumin, Karnofsky Performance Scale score, and Edmonton Symptom Assessment System score were independent prognosticators. Further studies are needed to provide a prognostic instrument applicable in local clinical settings.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Neoplasms
Type of study:
Observational_studies
/
Prognostic_studies
Aspects:
Patient_preference
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Hong Kong Med J
Journal subject:
MEDICINA
Year:
2007
Document type:
Article
Affiliation country:
Hong Kong