Successful validation of the palliative prognostic score in terminally illcancer patients

The aim of this work was to validate a previously constructed prognostic sc ore for terminally ill cancer patients in order to determine ifs value in c linical practice. The Palliative Prognostic Score (PaP Score) was tested on a population, of 451 evaluable patients consecutively entered in the hospi ce programs of 14 Italian Palliative Care Centers. The score subdivided pat ients into three specific risk classes based on the following six predictiv e factors of death, dyspnea, anorexia, Karnofsky Performance Status (KPS), Clinical Prediction of Survival (CPS), total white blood count (WBC), and l ymphocyte percentage. The performance of the PaP Score index in the trainin g and testing sets was evaluated by comparing mortality rates in the 3 prog nostic risk categories. The score uas able to subdivide the validation-inde pendent case series into three risk groups. Median survival was 76 days in group A (with a 86.6% probability of 30-day survival), 32 days in group B ( with a 51.6% probability of 30-day survival), and 14 days in group C (with a 16.9% probability of 30-day survival). Survival medians were remarkably s imilar to those of the training set (64 days in group A, 32 days in group B , and I I days in group C). In the complex process of staging terminally il l patients, the PaP Score is a simple instrument which permits a more accur ate quantification of expected survival. It has been validated on an indepe ndent case series and is thus suitable for use in clinical practice. (C) U. S. Cancer Pain Relief Committee, 1999.