Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Via P. Maroncelli 40, 47014 Meldola (FC), Italy.
Oncologist. 2012;17(3):446-54. doi: 10.1634/theoncologist.2011-0397. Epub 2012 Feb 29.
Predicting prognosis in advanced cancer aids physicians in clinical decision making and can help patients and their families to prepare for the time ahead.
This multicenter, observational, prospective, nonrandomized population-based study evaluated life span prediction of four prognostic scores used in palliative care: the original palliative prognostic score (PaP Score), a variant of PaP Score including delirium (D-PaP Score), the Palliative Performance Scale, and the Palliative Prognostic Index.
A total of 549 patients were enrolled onto the study. Median survival of the entire group was 22 days (95% confidence intervals [95% CI] = 19-24). All four prognostic models discriminated well between groups of patients with different survival probabilities. Log-rank tests were all highly significant (p < .0001). The PaP and D-PaP scores were the most accurate, with a C index of 0.72 (95% CI = 0.70-0.73) and 0.73 (95% CI = 0.71-0.74), respectively.
It can be confirmed that all four prognostic scores used in palliative care studies accurately identify classes of patients with different survival probabilities. The PaP Score has been extensively validated and shows high accuracy and reproducibility in different settings.
预测晚期癌症患者的预后有助于医生做出临床决策，并帮助患者及其家属为未来做好准备。
这项多中心、观察性、前瞻性、非随机的基于人群的研究评估了姑息治疗中使用的四种预后评分对生存期的预测能力：原始姑息预后评分（PaP 评分）、包含谵妄的 PaP 评分变体（D-PaP 评分）、姑息治疗表现量表和姑息预后指数。
共有 549 名患者入组该研究。全组患者的中位生存期为 22 天（95%置信区间 [95%CI] = 19-24）。所有四种预后模型均能很好地区分具有不同生存概率的患者组。对数秩检验均具有高度显著性（p <.0001）。PaP 和 D-PaP 评分最准确，C 指数分别为 0.72（95%CI = 0.70-0.73）和 0.73（95%CI = 0.71-0.74）。
可以确认，姑息治疗研究中使用的所有四种预后评分都能准确识别具有不同生存概率的患者群体。PaP 评分已得到广泛验证，在不同环境下具有较高的准确性和可重复性。
