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Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer

Predicting survival of advanced cancer patients (ACPs) is a difficult task. We aimed at developing and testing a new prognostic tool in ACPs when they were first referred to palliative care (PC). A total of 497 patients were analyzed in this study (development sample, n = 221; validation sample, n =...

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Autores principales: Paiva, Carlos Eduardo, Paiva, Bianca Sakamoto Ribeiro, de Paula Pântano, Naitielle, Preto, Daniel D’Almeida, de Oliveira, Cleyton Zanardo, Yennurajalingam, Sriram, Hui, David, Bruera, Eduardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051167/
https://www.ncbi.nlm.nih.gov/pubmed/29856126
http://dx.doi.org/10.1002/cam4.1582
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author Paiva, Carlos Eduardo
Paiva, Bianca Sakamoto Ribeiro
de Paula Pântano, Naitielle
Preto, Daniel D’Almeida
de Oliveira, Cleyton Zanardo
Yennurajalingam, Sriram
Hui, David
Bruera, Eduardo
author_facet Paiva, Carlos Eduardo
Paiva, Bianca Sakamoto Ribeiro
de Paula Pântano, Naitielle
Preto, Daniel D’Almeida
de Oliveira, Cleyton Zanardo
Yennurajalingam, Sriram
Hui, David
Bruera, Eduardo
author_sort Paiva, Carlos Eduardo
collection PubMed
description Predicting survival of advanced cancer patients (ACPs) is a difficult task. We aimed at developing and testing a new prognostic tool in ACPs when they were first referred to palliative care (PC). A total of 497 patients were analyzed in this study (development sample, n = 221; validation sample, n = 276). From 35 initial putative prognostic variables, 14 of them were selected for multivariable Cox regression analyses; the most accurate final model was identified by backward variable elimination. Parameters were built into a nomogram to estimate the probability of patient survival at 30, 90, and 180 days. Calibration and discrimination properties of the Barretos Prognostic Nomogram (BPN) were evaluated in the validation phase of the study. The BPN was composed of 5 parameters: sex, presence of distant metastasis, Karnofsky Performance Status (KPS), white blood cell (WBC) count, and serum albumin concentration. The C‐index was 0.71. The values of the area under the curve (AUC) of the receiver operating characteristic (ROC) curve were 0.84, 0.74, and 0.74 at 30, 90, and 180 days, respectively. There were good calibration results according to the Hosmer‐Lemeshow test. The median survival times were 313, 129, and 37 days for the BPN scores <25th percentile (<125), 25th to 75th percentile (125‐175), and >75th percentile (>175), respectively (P < .001). The BPN is a new prognostic tool with adequate calibration and discrimination properties. It is now available to assist oncologists and palliative care physicians in estimating the survival of adult patients with advanced solid tumors.
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spelling pubmed-60511672018-07-20 Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer Paiva, Carlos Eduardo Paiva, Bianca Sakamoto Ribeiro de Paula Pântano, Naitielle Preto, Daniel D’Almeida de Oliveira, Cleyton Zanardo Yennurajalingam, Sriram Hui, David Bruera, Eduardo Cancer Med Clinical Cancer Research Predicting survival of advanced cancer patients (ACPs) is a difficult task. We aimed at developing and testing a new prognostic tool in ACPs when they were first referred to palliative care (PC). A total of 497 patients were analyzed in this study (development sample, n = 221; validation sample, n = 276). From 35 initial putative prognostic variables, 14 of them were selected for multivariable Cox regression analyses; the most accurate final model was identified by backward variable elimination. Parameters were built into a nomogram to estimate the probability of patient survival at 30, 90, and 180 days. Calibration and discrimination properties of the Barretos Prognostic Nomogram (BPN) were evaluated in the validation phase of the study. The BPN was composed of 5 parameters: sex, presence of distant metastasis, Karnofsky Performance Status (KPS), white blood cell (WBC) count, and serum albumin concentration. The C‐index was 0.71. The values of the area under the curve (AUC) of the receiver operating characteristic (ROC) curve were 0.84, 0.74, and 0.74 at 30, 90, and 180 days, respectively. There were good calibration results according to the Hosmer‐Lemeshow test. The median survival times were 313, 129, and 37 days for the BPN scores <25th percentile (<125), 25th to 75th percentile (125‐175), and >75th percentile (>175), respectively (P < .001). The BPN is a new prognostic tool with adequate calibration and discrimination properties. It is now available to assist oncologists and palliative care physicians in estimating the survival of adult patients with advanced solid tumors. John Wiley and Sons Inc. 2018-06-01 /pmc/articles/PMC6051167/ /pubmed/29856126 http://dx.doi.org/10.1002/cam4.1582 Text en © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Paiva, Carlos Eduardo
Paiva, Bianca Sakamoto Ribeiro
de Paula Pântano, Naitielle
Preto, Daniel D’Almeida
de Oliveira, Cleyton Zanardo
Yennurajalingam, Sriram
Hui, David
Bruera, Eduardo
Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer
title Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer
title_full Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer
title_fullStr Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer
title_full_unstemmed Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer
title_short Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer
title_sort development and validation of a prognostic nomogram for ambulatory patients with advanced cancer
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051167/
https://www.ncbi.nlm.nih.gov/pubmed/29856126
http://dx.doi.org/10.1002/cam4.1582
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