Symptom improvement as prognostic factor for survival in cancer patients undergoing palliative care: a pilot study.
Background: The Edmonton Symptom Assessment Scale (ESAS) is a validated tool for physical symptom assessment in palliative care practice which evaluates symptoms through a numeric scale from 0 to 10. The use of symptom improvement as a prognostic factor is controversial. To this purpose, a pilot stu...
| Publicado en: | Supportive Care in Cancer Vol. 20; no. 6; pp. 1221 - 1227 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Jun2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104562834&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104562834 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09414355 O1J jtl: Supportive Care in Cancer issn: 09414355 maglogo: N pubinfo: dt: Jun2012 vid: 20 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104562834 NLM21688165 2011542344 10.1007/s00520-011-1207-8 NLM21688165 104562834 ppf: 1221 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Symptom improvement as prognostic factor for survival in cancer patients undergoing palliative care: a pilot study. aug: au: Narducci F Grande R Mentuccia L Trapasso T Sperduti I Magnolfi E Fariello AM Gemma D Gamucci T Narducci, Filomena Grande, Roberta Mentuccia, Lucia Trapasso, Tiziana Sperduti, Isabella Magnolfi, Emanuela Fariello, Anna Maria Gemma, Donatello Gamucci, Teresa affil: Medical Oncology Unit, Ospedale S.S. Trinità, Sora, ASL Frosinone, Italy sug: subj: Carcinoma, Non-Small-Cell Lung Therapy Gastrointestinal Neoplasms Therapy Lung Neoplasms Therapy Palliative Care Methods Aged Aged, 80 and Over Asthenia Etiology Carcinoma, Non-Small-Cell Lung Pathology Female Gastrointestinal Neoplasms Pathology Hospitalization Human Karnofsky Performance Status Lung Neoplasms Pathology Male Middle Age Multivariate Analysis Outcomes (Health Care) Pilot Studies Prognosis Severity of Illness Indices Survival Analysis Scales Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Background: The Edmonton Symptom Assessment Scale (ESAS) is a validated tool for physical symptom assessment in palliative care practice which evaluates symptoms through a numeric scale from 0 to 10. The use of symptom improvement as a prognostic factor is controversial. To this purpose, a pilot study in advanced cancer patients now undergoing only palliative care was conducted.Methods: Patients were considered eligible if no longer able to receive any anticancer treatment; they were scheduled to undergo ESAS assessment at the hospitalization and hospital discharge time points. Symptoms' scores were divided into three severity classes: mild, moderate and severe. Differences across symptoms' classes between hospitalization and hospital discharge time points were analysed with the paired-data McNemar test, according to tumour types.Results: ESAS assessment was administered to 68 patients with gastrointestinal (39 patients) and non-small cell lung cancer (29 patients); median age was 69 years; Karnofsky Performance Status was 50 in 27 (39.7%) patients and >50 in 41 (60.3%) patients. Palliative Prognostic Score was A for 26 (38.2%) patients, B for 37 (54.4%) patients and C for 5 (7.4%) patients. A statistically significant reduction of severe severity class rates was observed. Symptom improvement correlates with survival improvement: Palliative Prognostic Score (hazard ratio (HR) 2.95, 95% CI 1.35-6.41, p = 0.006) and anorexia (HR 3.21, 95% 1.33-7.72, p = 0.009) appear to be prognostic factors for survival at the multivariate analysis for gastrointestinal cancer patients; asthenia is the only significant variable (HR 5.11, 95% CI 1.86-14.03, p = 0.002) for non-small cell lung cancer patients.Conclusions: Symptom improvement according to ESAS after palliative care treatment represents an important prognostic for survival in patients no longer suitable to receive any anticancer active therapies. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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