Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-23T15:39:44.650Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of Objective Prognostic Score and Palliative Prognostic Score performance in inpatients with advanced cancer in Japan and Korea

Published online by Cambridge University Press:  05 October 2021

Yusuke Hiratsuka Open the ORCID record for Yusuke Hiratsuka [Opens in a new window] ,
Daye Kim ,
Sang-Yeon Suh Open the ORCID record for Sang-Yeon Suh [Opens in a new window] ,
Sun-Hyun Kim ,
Seok-Joon Yoon ,
Su-Jin Koh ,
Shin Ae Park ,
Ji-Yeon Seo ,
Jung Hye Kwon  and
Jeanno Park
...Show all authors
Yusuke Hiratsuka
Affiliation:
Department of Palliative Medicine, Takeda General Hospital, Aizuwakamatsu, Japan Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
Daye Kim
Affiliation:
Department of Family Medicine, Hospice and Palliative Care Center, Dongguk University Ilsan Hospital, Goyang, South Korea
Sang-Yeon Suh*
Affiliation:
Department of Family Medicine, Hospice and Palliative Care Center, Dongguk University Ilsan Hospital, Goyang, South Korea Department of Medicine, Dongguk University Medical School, Seoul, South Korea
Sun-Hyun Kim
Affiliation:
Department of Family Medicine, School of Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon, South Korea
Seok-Joon Yoon
Affiliation:
Department of Family Medicine, Chungnam National University Hospital, Daejeon, South Korea
Su-Jin Koh
Affiliation:
Department of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, South Korea
Shin Ae Park
Affiliation:
Department of Family Medicine, Hospice and Palliative Care Center, Seobuk Hospital, Seoul Metropolitan Government, Seoul, South Korea
Ji-Yeon Seo*
Affiliation:
Department of Family Medicine, Hospice and Palliative Care Center, Seobuk Hospital, Seoul Metropolitan Government, Seoul, South Korea
Jung Hye Kwon
Affiliation:
Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
Jeanno Park
Affiliation:
Department of Internal Medicine, Bobath Hospital, Seongnam, South Korea
Youngmin Park
Affiliation:
Department of Family Medicine, Hospice and Palliative Care Center, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
Sun Wook Hwang
Affiliation:
Department of Family Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
Eon Sook Lee
Affiliation:
Department of Family Medicine, Ilsan-Paik Hospital, College of Medicine, Inje University, Goyang, South Korea
Hana Choi
Affiliation:
Department of Statistics, Dongguk University, Seoul, South Korea
Hong-Yup Ahn
Affiliation:
Department of Statistics, Dongguk University, Seoul, South Korea
Shao-Yi Cheng
Affiliation:
Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
Ping-Jen Chen
Affiliation:
Department of Family Medicine, Kaohsiung Medical University Hospital, and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
Takashi Yamaguchi
Affiliation:
Division of Palliative Care, Konan Medical Center, Kobe, Japan
Tatsuya Morita
Affiliation:
Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
Satoru Tsuneto
Affiliation:
Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Masanori Mori
Affiliation:
Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
Akira Inoue
Affiliation:
Department of Palliative Medicine, Takeda General Hospital, Aizuwakamatsu, Japan
EASED Investigators
Affiliation:
Department of Palliative Medicine, Takeda General Hospital, Aizuwakamatsu, Japan
*
Author for correspondence: Sang-Yeon Suh, Department of Medicine, Dongguk University Medical School, Pildong 1-30, Jung-gu, Seoul, South Korea. E-mail: lisasuhmd@hotmail.com
Author for correspondence: Sang-Yeon Suh, Department of Medicine, Dongguk University Medical School, Pildong 1-30, Jung-gu, Seoul, South Korea. E-mail: lisasuhmd@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Accurate prognostication is important for patients and their families to prepare for the end of life. Objective Prognostic Score (OPS) is an easy-to-use tool that does not require the clinicians’ prediction of survival (CPS), whereas Palliative Prognostic Score (PaP) needs CPS. Thus, inexperienced clinicians may hesitate to use PaP. We aimed to evaluate the accuracy of OPS compared with PaP in inpatients in palliative care units (PCUs) in three East Asian countries.

Method

This study was a secondary analysis of a cross-cultural, multicenter cohort study. We enrolled inpatients with far-advanced cancer in PCUs in Japan, Korea, and Taiwan from 2017 to 2018. We calculated the area under the receiver operating characteristics (AUROC) curve to compare the accuracy of OPS and PaP.

Results

A total of 1,628 inpatients in 33 PCUs in Japan and Korea were analyzed. OPS and PaP were calculated in 71.7% of the Japanese patients and 80.0% of the Korean patients. In Taiwan, PaP was calculated for 81.6% of the patients. The AUROC for 3-week survival was 0.74 for OPS in Japan, 0.68 for OPS in Korea, 0.80 for PaP in Japan, and 0.73 for PaP in Korea. The AUROC for 30-day survival was 0.70 for OPS in Japan, 0.71 for OPS in Korea, 0.79 for PaP in Japan, and 0.74 for PaP in Korea.

Significance of results

Both OPS and PaP showed good performance in Japan and Korea. Compared with PaP, OPS could be more useful for inexperienced physicians who hesitate to estimate CPS.

Keywords

Advanced cancerEast AsiaObjective prognostic scorePalliative prognostic scorePrognostication
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 5 , October 2022 , pp. 662 - 670
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Amano, K, Maeda, I, Shimoyama, S, et al. (2015) The accuracy of physicians’ clinical predictions of survival in patients with advanced cancer. Journal of Pain and Symptom Management 50, 139–146.CrossRefGoogle ScholarPubMed
Baba, M, Maeda, I, Morita, T, et al. (2015) Survival prediction for advanced cancer patients in the real world: A comparison of the palliative prognostic score, delirium-palliative prognostic score, palliative prognostic index and modified prognosis in palliative care study predictor model. European Journal of Cancer 51, 1618–1629.CrossRefGoogle ScholarPubMed
Chih, AH, Su, P, Hu, WY, et al. (2016) The changes of ethical dilemmas in palliative care. A lesson learned from comparison between 1998 and 2013 in Taiwan. Medicine 95, e2323.CrossRefGoogle ScholarPubMed
Christakis, NA (1999) Prognostication and bioethics. Daedalus 128, 197–214.Google ScholarPubMed
Christakis, NA and Lamont, EB (2000) Extent and determinants of error in doctors’ prognoses in terminally ill patients: Prospective cohort study. BMJ 320, 469–472.CrossRefGoogle ScholarPubMed
Glare, P and Virik, K (2001) Independent prospective validation of the PaP score in terminally ill patients referred to a hospital-based palliative medicine consultation service. Journal of Pain and Symptom Management 22, 891–898.CrossRefGoogle ScholarPubMed
Glare, P, Virik, K, Jones, M, et al. (2003) A systematic review of physicians’ survival predictions in terminally ill cancer patients. BMJ 327, 195–198.CrossRefGoogle ScholarPubMed
Glare, PA, Eychmueller, S and McMahon, P (2004) Diagnostic accuracy of the palliative prognostic score in hospitalized patients with advanced cancer. Journal of Clinical Oncology 22, 4823–4828.CrossRefGoogle ScholarPubMed
Glare, P, Sinclair, C, Downing, M, et al. (2008) Predicting survival in patients with advanced disease. European Journal of Cancer 44, 1146–1156.CrossRefGoogle ScholarPubMed
Hui, D, Ross, J, Park, M, et al. (2019) Predicting survival in patients with advanced cancer in the last weeks of life: How accurate are prognostic models compared to clinicians’ estimates? Palliative Medicine 34, 126–133.CrossRefGoogle ScholarPubMed
Jho, HJ, Suh, SY, Yoon, S, et al. (2016) Prospective validation of the objective prognostic score for advanced cancer patients in diverse palliative settings. Journal of Pain and Symptom Management 52, 420–427.CrossRefGoogle ScholarPubMed
Kurashima, AY, Latorre, MDRDDO and Camargo, B (2010) A palliative prognostic score for terminally ill children and adolescents with cancer. Pediatric Blood and Cancer 55, 1167–1171.CrossRefGoogle ScholarPubMed
Lau, F, Cloutier-Fisher, D, Kuziemsky, C, et al. (2007) A systematic review of prognostic tools for estimating survival time in palliative care. Journal of Palliative Care 23, 93–112.CrossRefGoogle ScholarPubMed
Lin, WY, Chiu, TY, Ho, CT, et al. (2014) Hospice shared-care saved medical expenditure and reduced the likelihood of intensive medical utilization among advanced cancer patients in Taiwan – A nationwide survey. Supportive Care in Cancer 22, 1907–1914.CrossRefGoogle ScholarPubMed
Maltoni, M, Nanni, O, Derni, S, et al. (1994) Clinical prediction of survival is more accurate than the Karnofsky performance status in estimating life span of terminally ill cancer patients. European Journal of Cancer 30, 764–766.CrossRefGoogle Scholar
Maltoni, M, Caraceni, A, Brunelli, C, et al. (2005) Prognostic factors in advanced cancer patients: Evidence-based clinical recommendations – A study by the steering committee of the european association for palliative care. Journal of Clinical Oncology 23, 6240–6248.CrossRefGoogle Scholar
Maltoni, M, Scarpi, E, Pittureri, C, et al. (2012) Prospective comparison of prognostic scores in palliative care cancer populations. The Oncologist 17, 446–454.CrossRefGoogle ScholarPubMed
Miller, RJ (1991) Predicting survival in the advanced cancer patient. Henry Ford Hospital Medical Journal 39, 81–84.Google ScholarPubMed
Naylor, C, Cerqueira, L, Costa-Paiva, LH, et al. (2010) Survival of women with cancer in palliative care: Use of the palliative prognostic score in a population of Brazilian women. Journal of Pain and Symptom Management 39, 69–75.CrossRefGoogle Scholar
Numico, G, Occelli, M, Russi, EG, et al. (2011) Survival prediction and frequency of anticancer treatment in cancer patients hospitalized due to acute conditions. Role of clinical parameters and PaP score. Supportive Care in Cancer 19, 1823–1830.CrossRefGoogle ScholarPubMed
Pirovano, M, Maltoni, M, Nanni, O, et al. (1999) A new palliative prognostic score: A first step for the staging of terminally ill cancer patients. Journal of Pain and Symptom Management 17, 231–239.CrossRefGoogle ScholarPubMed
Stone, PC and Lund, S (2007) Predicting prognosis in patients with advanced cancer. Annals of Oncology 18, 971–976.CrossRefGoogle ScholarPubMed
Stone, P, Vickerstaff, V, Kalpakidou, A, et al. (2021) Prognostic tools or clinical predictions: Which are better in palliative care? PLoS One 16, e0249763.CrossRefGoogle ScholarPubMed
Suh, SY, Choi, YS, Shim, JY, et al. (2010) Construction of a new, objective prognostic score for terminally ill cancer patients: A multicenter study. Supportive Care in Cancer 18, 151–157.CrossRefGoogle ScholarPubMed
Tarumi, Y, Watanabe, SM, Lau, F, et al. (2011) Evaluation of the palliative prognostic score (PaP) and routinely collected clinical data in prognostication of survival for patients referred to a palliative care consultation service in an acute care hospital. Journal of Pain and Symptom Management 42, 419–431.CrossRefGoogle Scholar
Tassinari, D, Montanari, L, Maltoni, M, et al. (2008) The palliative prognostic score and survival in patients with advanced solid tumors receiving chemotherapy. Supportive Care in Cancer 16, 359–370.CrossRefGoogle ScholarPubMed
Tavares, T, Oliveira, M, Goncalves, J, et al. (2018) Predicting prognosis in patients with advanced cancer: A prospective study. Palliative Medicine 32, 413–416.CrossRefGoogle ScholarPubMed
Yates, JW, Chalmer, B and McKegney, FP (1980) Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer 45, 2220–2224.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed
Yoon, SJ, Jung, JG, Kim, JS, et al. (2014) Comparison of accuracy among prognostic scores for predicting life expectancy in Korean patients with cancer with weeks of survival. American Journal of Hospice and Palliative Care 31, 845–852.CrossRefGoogle ScholarPubMed
Yoon, SJ, Suh, SY, Lee, YJ, et al. (2017) Prospective validation of objective prognostic score for advanced cancer inpatients in South Korea: A multicenter study. Journal of Palliative Medicine 20, 65–68.CrossRefGoogle ScholarPubMed
Yoon, SJ, Suh, SY, Hui, D, et al. (2021) Accuracy of the palliative prognostic score with or without clinicians’ prediction of survival in patients with far advanced cancer. Journal of Pain and Symptom Management 61, 1180–1187.CrossRefGoogle ScholarPubMed