THE FINDINGS of a new study have identified a group of prognostic models with a good ability to predict survival in cancer patients receiving palliative care.
The research was presented at the ESMO Asia 2016 Congress in Singapore showing that the Six Adaptable Prognostic (SAP) models had a good ability to predict whether a patient would die within 1–3 months. The SAP models use laboratory measurements of albumin, neutrophil, and lactate dehydrogenase from blood tests which are also conducted as part of daily clinical practice.
The research was conducted as a sub-analysis of the Japan-prognostic assessment tools validation (J-ProVal) study. This sub-analysis included 1,015 cancer patients receiving palliative care in hospitals, care units, and through care services at home. To test the predictive value of the models, researchers carried out receiver operating characteristic analysis. They found that the area under the curve for predicting whether a patient would die within 1–3 months ranged from 0.75–0.80.
“The SAP models could be a promising decision aid for healthcare professionals and patients,” explained Dr Yo Uneno, Kyoto University, Kyoto, Japan. “Accurate prediction or survival allows patients adequate time to prepare for their impending death and is vital for planning effective palliative care,” he comments.
The models can be used at any point once treatment has begun. This means they could provide ongoing survival estimations that are used to inform whether a patient should receive different pharmacological treatment. Commenting on the findings of the study, Dr Grace Yang, National Cancer Centre, Singapore said: “Knowing the patient’s prognosis will facilitate decision making regarding trade-offs, not only for anticancer therapy, but for treatments directed at relieving symptoms. For example, in deciding between pain-relieving treatment with different time horizons for onset and duration of effect, with different side effects, risk profiles, and different financial costs.”
“As we get closer to knowing how long a cancer patient has to live, further studies exploring the ethical and psychological implications will also be worthwhile,” Dr Yang added.
Jack Redden, Reporter