Division of Gastroenterology, Tsukuba University Graduate School of Comprehensive Human Sciences, Tsukuba 305-8575, Japan.
Jpn J Clin Oncol. 2010 May;40(5):442-8. doi: 10.1093/jjco/hyp182. Epub 2010 Jan 18.
To develop a predicting tool for survival of terminally ill cancer patients.
This prospective, multicenter study was composed of two cohorts of samples: development and test. In the development sample of terminally ill cancer patients, 32 candidate predictors were studied to develop a new tool, Japan Palliative Oncology Study-Prognostic Index using the Cox proportional hazard model. Then the test sample was studied to validate Japan Palliative Oncology Study-Prognostic Index and compared it with the conventional predicting tools, such as palliative prognostic score and simplified palliative prognostic index.
Five significant predictors, physician's clinical prediction of survival, consciousness, pleural effusion, white blood cell count and lymphocyte % were derived from the analysis of 201 patients, and Japan Palliative Oncology Study-Prognostic Index was developed using these predictors. It could divide patients into three risk groups: low (A), intermediate (B) and high (C). Median survival times for Groups A, B and C were 51, 35 and 16 days, respectively. Survival probability for more than 30 days for Groups A, B and C in the development sample was 78%, 61% and 16%, respectively. Japan Palliative Oncology Study-Prognostic Index was studied in subsequent 208 patients for the test sample, and constant results (median survival times for Groups A, B and C; 67, 31 and 10 days, and survival probability for more than 30 days for Groups A, B and C; 81, 48 and 11%) were obtained. Palliative prognostic score can also predict three risk groups well, but simplified palliative prognostic index could not discriminate low risk from intermediate risk group.
Japan Palliative Oncology Study-Prognostic Index, a tool to predict survival, has been developed. Its reliability should be confirmed further in the future study, comparing with palliative prognostic score.
开发一种用于预测终末期癌症患者生存的工具。
这项前瞻性、多中心研究由两个样本队列组成：开发和测试。在终末期癌症患者的开发样本中，研究了 32 个候选预测因素，以使用 Cox 比例风险模型开发一种新的工具，即日本姑息肿瘤学研究-预后指数。然后研究了测试样本，以验证日本姑息肿瘤学研究-预后指数，并将其与传统预测工具（如姑息预后评分和简化姑息预后指数）进行比较。
从 201 例患者的分析中得出了 5 个显著的预测因素，即医生对生存的临床预测、意识、胸腔积液、白细胞计数和淋巴细胞%，并使用这些预测因素开发了日本姑息肿瘤学研究-预后指数。它可以将患者分为三个风险组：低（A）、中（B）和高（C）。A、B 和 C 组的中位生存时间分别为 51、35 和 16 天。A、B 和 C 组在开发样本中的 30 天以上生存率分别为 78%、61%和 16%。在随后的 208 例测试样本中研究了日本姑息肿瘤学研究-预后指数，得到了一致的结果（A、B 和 C 组的中位生存时间分别为 67、31 和 10 天，A、B 和 C 组 30 天以上生存率分别为 81%、48%和 11%）。姑息预后评分也可以很好地预测三个风险组，但简化姑息预后指数不能区分低风险和中风险组。
已经开发出一种用于预测生存的日本姑息肿瘤学研究-预后指数。在未来的研究中，应与姑息预后评分进一步确认其可靠性。
