|
Sign In to gain access to subscriptions and/or personal tools.
|
Survival prediction in terminal cancer patients: a systematic review of the medical literature
Antonio Viganò
Marlene Dorgan
Jeanette Buckingham
J.W. Scott Health Sciences Library University of Alberta, Edmonton
Eduardo Bruera
Department of Symptom Control and Palliative Care, University of Texas, Houston
Maria E Suarez-Almazor
Health Services Research, Baylor College of Medicine, University of Texas, Houston
The clinical significance of studies on survival predictors in terminal cancer patients is hindered by both methodological limitations and the difficulty of finding common predictors for all final events in cancer related deaths. To evaluate the published medical literature concerned with the survival of patients with terminal cancer and identify potential prognostic factors, major electronic databases including MEDLINE (1966–), CANCERLIT (1983–) and EMBASE (1988–) were searched up to September 1999. Studies were included in our review if published in English, were cohort studies, addressed the identification of clinical prognostic factors for survival and looked at samples with median survival of [.lessequal]3 months. Data extracted from selected papers included: sample size, median survival, type of study, sampling frame, cohort type, type of statistical analysis (univariate or multivariate), choice of models and underlying assumptions, predictors examined and their reported level of statistical significance. A total of 24 studies were found and reviewed. On the basis of these studies, performance status and the presence of cognitive failure, weight loss, dysphagia, anorexia and dyspnoea appear to be independent survival predictors in this population. Clinical estimation of survival by the treating physician appeared independently associated with survival but the magnitude of the association generally appeared small. Clinical predictions should be considered as one of many criteria, rather than as a unique criterion by which to choose therapeutic interventions or health care programmes for terminally ill cancer patients. The use of convenient samples as opposed to more representative inception cohorts, the inclusion of different variables in the statistical analyses and inappropriate statistical methods appear to be major limitations of the reviewed literature. Methodological improvements in the design and conduction of future studies may reduce the prognostic uncertainty in this population.
Key Words: systematic review • prognostic factors for survival • terminal cancer
Palliative Medicine, Vol. 14, No. 5,
363-374 (2000)
DOI: 10.1191/026921600701536192
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
E. Finlay and D. Casarett
Making Difficult Discussions Easier: Using Prognosis to Facilitate Transitions to Hospice
CA Cancer J Clin,
July 1, 2009;
59(4):
250 - 263.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Maguire, J. Cowie, C. Leadbetter, K. McCall, K. Swingler, L. McCann, and N. Kearney
The development of a side effect risk assessment tool (ASyMS(C)-SERAT) for use in patients with breast cancer undergoing adjuvant chemotherapy
Journal of Research in Nursing,
January 1, 2009;
14(1):
27 - 40.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P Stone, L Kelly, R Head, and S White
Development and validation of a prognostic scale for use in patients with advanced cancer
Palliative Medicine,
September 1, 2008;
22(6):
711 - 717.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A.-C. Barbot, P. Mussault, P. Ingrand, and J.-M. Tourani
Assessing 2-Month Clinical Prognosis in Hospitalized Patients With Advanced Solid Tumors
J. Clin. Oncol.,
May 20, 2008;
26(15):
2538 - 2543.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. W. Wijnia and I. J. P. M. Corstiaensen
A Poor Prognosis: Guide or Misleading?
American Journal of Hospice and Palliative Medicine,
March 1, 2008;
25(1):
5 - 8.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. W. G. Roe, P. Leslie, and M. J. Drinnan
Oropharyngeal dysphagia: the experience of patients with non-head and neck cancers receiving specialist palliative care
Palliative Medicine,
October 1, 2007;
21(7):
567 - 574.
[Abstract]
[PDF]
|
|
|
|
|
|
|
L Kelly, S White, and P. Stone
The B12/CRP index as a simple prognostic indicator in patients with advanced cancer: a confirmatory study
Ann. Onc.,
August 1, 2007;
18(8):
1395 - 1399.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Estfan, M. P. Davis, D. Walsh, J. Heintz, P. E. Shaheen, B. Cheema, S. B. LeGrand, and R. L. Lagman
The Business of Palliative Medicine--Part 5: Service Utilization in a Comprehensive Integrated Program
American Journal of Hospice and Palliative Medicine,
June 1, 2007;
24(3):
211 - 218.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P. Stone and S Lund
Predicting prognosis in patients with advanced cancer
Ann. Onc.,
June 1, 2007;
18(6):
971 - 976.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. E Shragge, W. V Wismer, K. L Olson, and V. E Baracos
The management of anorexia by patients with advanced cancer: a critical review of the literature
Palliative Medicine,
September 1, 2006;
20(6):
623 - 629.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. A. Hayden, P. Cote, and C. Bombardier
Evaluation of the quality of prognosis studies in systematic reviews.
Ann Intern Med,
March 21, 2006;
144(6):
427 - 437.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. M. McMahon, D. L. Hurley, P. S. Kamath, and P. S. Mueller
Medical and Ethical Aspects of Long-term Enteral Tube Feeding
Mayo Clin. Proc.,
November 1, 2005;
80(11):
1461 - 1476.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. L. Mackenzie, N. Bedard, S. S. Wing, and V. E. Baracos
A proinflammatory tumor that activates protein degradation sensitizes rats to catabolic effects of endotoxin
Am J Physiol Endocrinol Metab,
October 1, 2005;
289(4):
E527 - E533.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. S. Nathan, J. H. Healey, D. Mellano, B. Hoang, I. Lewis, C. D. Morris, E. A. Athanasian, and P. J. Boland
Survival in Patients Operated on for Pathologic Fracture: Implications for End-of-Life Orthopedic Care
J. Clin. Oncol.,
September 1, 2005;
23(25):
6072 - 6082.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Maltoni, A. Caraceni, C. Brunelli, B. Broeckaert, N. Christakis, S. Eychmueller, P. Glare, M. Nabal, A. Vigano, P. Larkin, et al.
Prognostic Factors in Advanced Cancer Patients: Evidence-Based Clinical Recommendations--A Study by the Steering Committee of the European Association for Palliative Care
J. Clin. Oncol.,
September 1, 2005;
23(25):
6240 - 6248.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J Hjermstad, J. H Loge, and S. Kaasa
Methods for assessment of cognitive failure and delirium in palliative care patients: implications for practice and research
Palliative Medicine,
September 1, 2004;
18(6):
494 - 506.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. Maltoni and D. Tassinari
Prognostic assessment in terminally ill cancer patients: from evidence-based knowledge to a patient-physician relationship and back
Palliative Medicine,
January 1, 2004;
18(1):
77 - 79.
[PDF]
|
|
|
|
|
|
|
P. Glare, K. Virik, M. Jones, M. Hudson, S. Eychmuller, J. Simes, and N. Christakis
A systematic review of physicians' survival predictions in terminally ill cancer patients
BMJ,
July 24, 2003;
327(7408):
195.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Levack
Editorial I: Live and let die? A structured approach to decision-making about resuscitation
Br. J. Anaesth.,
November 1, 2002;
89(5):
683 - 686.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. S. Drought and B. A. Koenig
"Choice" in End-of-Life Decision Making: Researching Fact or Fiction?
Gerontologist,
October 1, 2002;
42(90003):
114 - 128.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Tassinari, M. Maltoni, and D. Amadori
Reply: Prediction of survival in terminally ill cancer patients: why we cannot avoid an evidence-based palliative medicine
Ann. Onc.,
August 1, 2002;
13(8):
1322 - 1323.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Addington-Hall and L. Kalra
Measuring quality of life: Who should measure quality of life?
BMJ,
June 9, 2001;
322(7299):
1417 - 1420.
[Full Text]
[PDF]
|
|
|
|
|
