M. Maltoni et al., BIOLOGICAL INDEXES PREDICTIVE OF SURVIVAL IN 519 ITALIAN TERMINALLY ILL CANCER-PATIENTS, Journal of pain and symptom management, 13(1), 1997, pp. 1-9
The knowledge of prognostic factors capable of subdividing cancer pati
ents into groups having homogenous survival times is useful even in ve
ry advanced stages of illness. This prospective multicenter study asse
ssed these prognostic factors in 530 terminal patients with solid tumo
rs who were undergoing only palliative care. Thirteen hematological an
d urinary parameters were assessed on admission and every 28 days ther
eafter In 519 assessable patients with a median survival of 32 days, s
ix biological parameters demonstrated a statistically significant pred
ictive prognosis. A poor prognosis was predicted by high total white b
lood count (WBC) (P < 0.0001), high neutrophil percentage (P < 0.0001)
, low lymphocyte percentage (P < 0.0001), low serum albumin level (P =
0.0015), low pseudocholinesterase level (P < 0.0001), and high protei
nuria (P = 0.0064). Multiple regression analysis showed that only WBC,
lymphocyte percentage and pseudocholinesterase level were independent
predictors of survival. The individualization of biological parameter
s having an independent prognostic capacity is a useful step in the at
tempt to identify subsets of patients with a homogeneous prognosis. Th
e biological factors needed are easily detected by means of a simple b
lood test and do not require invasive operations on patients who are a
lready debilitated. (C) U.S. Cancer Pain Relief Committee, 1997.