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在医院接受临终关怀的癌症患者中,肝脏特异性转移是一个独立的预后因素。

Liver-specific metastases as an independent prognostic factor in cancer patients receiving hospice care in hospital.

机构信息

Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

出版信息

BMC Palliat Care. 2023 May 24;22(1):62. doi: 10.1186/s12904-023-01180-x.

Abstract

BACKGROUND

Survival prediction is important in cancer patients receiving hospice care. Palliative prognostic index (PPI) and palliative prognostic (PaP) scores have been used to predict survival in cancer patients. However, cancer primary site with metastatic status, enteral feeding tubes, Foley catheter, tracheostomy, and treatment interventions are not considered in aforementioned tools. The study aimed to investigate the cancer features and potential clinical factors other than PPI and PaP to predict patient survival.

METHODS

We conducted a retrospective study for cancer patients admitted to a hospice ward between January 2021 and December 2021. We examined the correlation of PPI and PaP scores with survival time since hospice ward admission. Multiple linear regression was used to test the potential clinical factors other than PPI and PaP for predicting survival.

RESULTS

A total of 160 patients were enrolled. The correlation coefficients for PPI and PaP scores with survival time were -0.305 and -0.352 (both p < 0.001), but the predictabilities were only marginal at 0.087 and 0.118, respectively. In multiple regression, liver metastasis was an independent poor prognostic factor as adjusted by PPI (β = -8.495, p = 0.013) or PaP score (β = -7.139, p = 0.034), while feeding gastrostomy or jejunostomy were found to prolong survival as adjusted by PPI (β = 24.461, p < 0.001) or PaP score (β = 27.419, p < 0.001).

CONCLUSIONS

Association between PPI and PaP with patient survival in cancer patients at their terminal stages is low. The presence of liver metastases is a poor survival factor independent of PPI and PaP score.

摘要

背景

对于接受临终关怀的癌症患者,生存预测很重要。姑息预后指数(PPI)和姑息预后(PaP)评分已被用于预测癌症患者的生存。然而,上述工具未考虑癌症原发部位的转移状态、肠内喂养管、 Foley 导管、气管造口术和治疗干预。本研究旨在探讨除 PPI 和 PaP 之外的癌症特征和潜在临床因素,以预测患者的生存。

方法

我们对 2021 年 1 月至 2021 年 12 月期间入住临终关怀病房的癌症患者进行了回顾性研究。我们检查了 PPI 和 PaP 评分与临终关怀病房入院后生存时间的相关性。多元线性回归用于检验除 PPI 和 PaP 之外的潜在临床因素对生存的预测作用。

结果

共纳入 160 例患者。PPI 和 PaP 评分与生存时间的相关系数分别为-0.305 和-0.352(均<0.001),但预测能力仅为 0.087 和 0.118。多元回归分析显示,肝转移是 PPI(β=-8.495,p=0.013)或 PaP 评分(β=-7.139,p=0.034)校正后的独立不良预后因素,而胃或空肠造口术喂养被发现可延长 PPI(β=24.461,p<0.001)或 PaP 评分(β=27.419,p<0.001)校正后的生存时间。

结论

在癌症终末期患者中,PPI 和 PaP 与患者生存的相关性较低。肝转移的存在是一个独立于 PPI 和 PaP 评分的不良生存因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/371d/10207633/6d4fdbc3449d/12904_2023_1180_Fig1_HTML.jpg

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