Literature DB >> 28472235

Clinical validation of a prognostic tool in a population of outpatients treated for incurable cancer undergoing anticancer therapy: PRONOPALL study.

H Bourgeois1,2, F Grudé2, P Solal-Céligny1, O Dupuis1, E Voog1, G Ganem1, F Denis1, M Zinger1, L Juhel-Voog1, C Lafond1, P Maillart3, O Capitain3, R Delva3, P Soulié3, S Abadie-Lacourtoisie3, V Guérin-Meyer3, M E Morin-Meschin3, J M Commer3, A Gangler3, B d'Aillières3, A Zannetti3, E Bourbouloux4, D Berton-Rigault4, S Lebouvier-Sadot4, M Kaassis5, J Baudon5, Y H Lam5, A Bizieux6, M Marcq6, J Edeline7, F Le Du7, C Lefeuvre7, P Deguiral8, V Delecroix8, E Blot9, J Egreteau10, M J Goudier10, R Lamy10, M Ferec11, X Artignan12, S Corbinais13, H Morel13, A C Hardy-Bessard14, C Alleaume15, E Naudeix16, O Cojocarasu17, J P Metges2, C Riché2, E Gamelin18, D Déniel-Lagadec2, F Marhuenda2, P Ingrand19, J Y Douillard2,4.   

Abstract

BACKGROUND: In 2008, a study of the characteristics of hospitalised patients led to the development of a prognostic tool that distinguished three populations with significantly different 2-month survival rates. The goal of our study aimed at validating prospectively this prognostic tool in outpatients treated for cancer in terminal stage, based on four factors: performance status (ECOG) (PS), number of metastatic sites, serum albumin and lactate dehydrogenase. PATIENTS AND METHODS: PRONOPALL is a multicentre study of current care. About 302 adult patients who met one or more of the following criteria: life expectancy under 6 months, performance status ≥ 2 and disease progression during the previous chemotherapy regimen were included across 16 institutions between October 2009 and October 2010. Afterwards, in order to validate the prognostic tool, the score was ciphered and correlated to patient survival.
RESULTS: Totally 262 patients (87%) were evaluable (27 patients excluded and 13 unknown score). Median age was 66 years [37-88], and women accounted for 59%. ECOG PS 0-1 (46%), PS 2 (37%) and PS 3-4 (17%). The primary tumours were: breast (29%), colorectal (28%), lung (13%), pancreas (12%), ovary (11%) and other (8%). About 32% of patients presented one metastatic site, 35% had two and 31% had more than two. The median lactate dehydrogenase level was 398 IU/l [118-4314]; median serum albumin was 35 g/l [13-54]. According to the PRONOPALL prognostic tool, the 2-month survival rate was 92% and the median survival rate was 301 days [209-348] for the 130 patients in population C, 66% and 79 days [71-114] for the 111 patients in population B, and 24% and 35 days for [14-56] the 21 patients in population A. These three populations survival were statistically different (P <0.0001).
CONCLUSION: PRONOPALL study confirms the three prognostic profiles defined by the combination of four factors. This PRONOPALL score is a useful decision-making tool in daily practice.
© The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Entities:  

Keywords:  Performance Status (PS ECOG); lactate dehydrogenase; palliative care; prognostic tool; serum albumin; survival at 2 months

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Year:  2017        PMID: 28472235     DOI: 10.1093/annonc/mdx172

Source DB:  PubMed          Journal:  Ann Oncol        ISSN: 0923-7534            Impact factor:   32.976


  10 in total

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8.  PALLIA-10, a screening tool to identify patients needing palliative care referral in comprehensive cancer centers: A prospective multicentric study (PREPA-10).

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  10 in total

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