Hidemasa Nagai1, Natsuko Kawai2, Norihiro Yuasa3,4. 1. Department of Gastrointestinal Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan. 2. Department of Palliative Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan. 3. Department of Gastrointestinal Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan. nyuasa0257@gmail.com. 4. Department of Palliative Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan. nyuasa0257@gmail.com.
Abstract
BACKGROUND: Few studies have developed an easy scoring system for the short-term survival of patients with gastrointestinal (GI) malignancy. METHODS: A total of 816 terminally ill patients with GI malignancy were admitted to our palliative care unit. They were randomly divided into the investigation (n = 490) and validation (n = 326) groups. A total of 19 laboratory blood parameters were analyzed. Receiver-operating characteristic analysis was performed for each blood factor, and the area under the curve was calculated to determine the predictive value for 14-day survival after the blood test. Multivariable logistic regression analysis was performed to identify significant independent prognostic factors for 14-day mortality. To develop a scoring system for 14-day mortality, the laboratory prognostic score for gastrointestinal malignancy (GI-LPS) was calculated using the sum of indices of the independent prognostic factors. RESULTS: Multivariable analysis showed that 5 of 19 indices, namely total bilirubin ≥ 2.1 mg/dL, blood urea nitrogen ≥ 28 mg/dL, eosinophil percentage ≤ 0.5%, neutrophil-to-lymphocyte ratio ≥ 9.2, and platelet count ≤ 194 × 103/μL, were significant independent factors of 14-day survival. GI-LPS showed acceptable accuracy for 14-day mortality in the investigation and validation groups. GI-LPS 3 (including any three factors) predicted death within 14 days, with a sensitivity of 56-58%, a specificity of 82-87%, a positive predictive value of 48-50%, and a negative predictive value of 87-90%. CONCLUSIONS: GI-LPS showed an acceptable ability to predict 14-day survival and can provide additional information to conventional prognostic scores.
BACKGROUND: Few studies have developed an easy scoring system for the short-term survival of patients with gastrointestinal (GI) malignancy. METHODS: A total of 816 terminally ill patients with GI malignancy were admitted to our palliative care unit. They were randomly divided into the investigation (n = 490) and validation (n = 326) groups. A total of 19 laboratory blood parameters were analyzed. Receiver-operating characteristic analysis was performed for each blood factor, and the area under the curve was calculated to determine the predictive value for 14-day survival after the blood test. Multivariable logistic regression analysis was performed to identify significant independent prognostic factors for 14-day mortality. To develop a scoring system for 14-day mortality, the laboratory prognostic score for gastrointestinal malignancy (GI-LPS) was calculated using the sum of indices of the independent prognostic factors. RESULTS: Multivariable analysis showed that 5 of 19 indices, namely total bilirubin ≥ 2.1 mg/dL, blood urea nitrogen ≥ 28 mg/dL, eosinophil percentage ≤ 0.5%, neutrophil-to-lymphocyte ratio ≥ 9.2, and platelet count ≤ 194 × 103/μL, were significant independent factors of 14-day survival. GI-LPS showed acceptable accuracy for 14-day mortality in the investigation and validation groups. GI-LPS 3 (including any three factors) predicted death within 14 days, with a sensitivity of 56-58%, a specificity of 82-87%, a positive predictive value of 48-50%, and a negative predictive value of 87-90%. CONCLUSIONS: GI-LPS showed an acceptable ability to predict 14-day survival and can provide additional information to conventional prognostic scores.
Authors: Richard A Smith; Lorraine Bosonnet; Michael Raraty; Robert Sutton; John P Neoptolemos; Fiona Campbell; Paula Ghaneh Journal: Am J Surg Date: 2008-07-17 Impact factor: 2.565
Authors: M Stotz; A Gerger; F Eisner; J Szkandera; H Loibner; A L Ress; P Kornprat; W AlZoughbi; W A Zoughbi; F S Seggewies; C Lackner; T Stojakovic; H Samonigg; G Hoefler; M Pichler Journal: Br J Cancer Date: 2013-06-25 Impact factor: 9.075