Effects of oral intake, symptom severity, and sex difference on cancer patient prognosis.

IF 2.8 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Supportive Care in Cancer Pub Date : 2025-01-09 DOI:10.1007/s00520-024-09124-8

Tetsuya Ito, Emi Tomizawa, Yuki Yano, Dai Akiyama, Haruko Konishi, Kiyozumi Takei, Masahiro Ikeda, Naoko Takahashi, Fumio Shaku

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Abstract

Purpose: For cancer patients, prognostication by physicians constitutes a fundamental basis of decision-making to manage the cancer journey, especially with advanced stages of cancer. Various tools such as the palliative prognostic index (PPI) have been established to estimate patient survival. Such reliable and widely applied tools unfortunately provide unexpected results of prognosis predictions in some cases. To support disease-related decision-making, this study explores factors associated with prognosis prediction outliers in patients with advanced cancer in palliative care units (PCUs).

Methods: For this retrospective observational study conducted at a PCU, we surveyed medical records of patients with advanced cancer admitted to our facility during August 2018-June 2022. Specifically, we collected data for the PPI, laboratory data, physical status, and psychological symptoms on admission.

Results: Our survey of data of 675 patients revealed that the presence and absence of severely reduced oral intake were significantly associated, respectively, with shorter (p < 0.001) and longer (p < 0.001) than estimated survival. Moreover, symptoms other than pain and female sex were associated, respectively, with shorter-than-expected and longer-than-expected survival.

Conclusion: The oral intake status of patients with advanced cancer in a PCU plays an important role in prognosis estimation. During prognosis, effects of symptoms other than pain and sex difference must also be considered. Although PPI-based prediction can provide a foundation for care management, cancer patients in more advanced stages of disease particularly require more detailed consideration.

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口服摄入量、症状严重程度及性别差异对癌症患者预后的影响。

目的：对于癌症患者，医生的预后是管理癌症旅程决策的基本依据，特别是对于晚期癌症。各种工具，如姑息预后指数（PPI）已建立估计患者的生存。不幸的是，这种可靠和广泛应用的工具在某些情况下提供了意想不到的预后预测结果。为了支持疾病相关决策，本研究探讨了姑息治疗单位（PCUs）晚期癌症患者预后预测异常值的相关因素。方法：对于这项在PCU进行的回顾性观察性研究，我们调查了2018年8月至2022年6月期间入院的晚期癌症患者的医疗记录。具体而言，我们收集了入院时PPI、实验室数据、身体状况和心理症状的数据。结果：我们对675例患者的调查数据显示，存在和不存在严重的口服摄入减少分别与较短的(p)显著相关。结论：PCU晚期癌症患者的口服摄入状况在预后评估中起重要作用。在预后时，除疼痛和性别差异外，还必须考虑其他症状的影响。虽然基于ppi的预测可以为护理管理提供基础，但更晚期的癌症患者尤其需要更详细的考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Supportive Care in Cancer 医学-康复医学

CiteScore

5.70

自引率

9.70%

发文量

751

审稿时长

3 months

期刊介绍： Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.