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Cancer Survival Analysis01:21

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Updated: May 24, 2025

Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
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Prognostic models for survival predictions in advanced cancer patients: a systematic review and meta-analysis.

Mong Yung Fung1, Yuen Lung Wong2, Ka Man Cheung3

  • 1Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. myfung@link.cuhk.edu.hk.

BMC Palliative Care
|March 2, 2025
PubMed
Summary

This systematic review found that the Palliative Prognostic Score (PaP) may be a useful tool for predicting survival in advanced cancer patients. Further research is needed to confirm its effectiveness for palliative care planning.

Keywords:
Advanced cancerPalliative carePrognostic modelPrognosticationSurvival

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Area of Science:

  • Oncology
  • Palliative Care
  • Biostatistics

Background:

  • Accurate prognostication is vital for palliative care (PC) planning in advanced cancer.
  • Clinical point-of-care prognostic models can aid clinician decision-making.
  • Timely PC referral impacts patient outcomes but varies in practice.

Purpose of the Study:

  • To systematically review and meta-analyze prognostic models for advanced cancer survival.
  • To identify and evaluate the performance of various clinical prognostic tools.
  • To inform the selection of models for palliative care decision support.

Main Methods:

  • Systematic literature search across major databases (Ovid Medline, Embase, CINAHL Ultimate, Scopus).
  • Inclusion criteria: incurable solid tumors, prognostic model validation, performance measurement.
  • Risk of bias assessed using PROBAST; meta-analysis of pooled C-statistics for survival prediction.

Main Results:

  • 35 studies evaluated 35 prognostic models; Palliative Prognostic Index (PPI), Palliative Prognostic Score (PaP), and Objective Prognostic Score (OPS) were common.
  • Pooled C-statistics for 30-day survival: PPI=0.68, PaP=0.76, OPS=0.69.
  • PaP showed higher pooled C-statistics for 21-day (0.80) and 30-day (0.76) survival prediction.
  • All included studies exhibited a high risk of bias.

Conclusions:

  • The Palliative Prognostic Score (PaP) demonstrates promising performance for survival prognostication.
  • Further validation and implementation studies are necessary.
  • High risk of bias in current studies necessitates cautious interpretation.