Survival prediction of terminally ill cancer patients by clinical symptoms: Development of a simple indicator

Background: Although accurate prediction of survival is essential for palli ative care, no clinical tools have been established. Methods: Performance status and clinical symptoms were prospectively assess ed on two independent series of terminally ill cancer patients (training se t, n = 150; testing set, n = 95). On the training set, the cases were divid ed into two groups with or without a risk factor for shorter than 3 and 6 w eeks survival, according to the way the classification achieved acceptable predictive value. The validity of this classification for survival predicti on was examined on the test samples. Results: The cases with performance status 10 or 20, dyspnea at rest or del irium were classified in the group with a predicted survival of shorter tha n 3 weeks. The cases with performance status 10 or 20, edema, dyspnea at re st or delirium were classified in the group with a predicted survival of sh orter than 6 weeks. On the training set, this classification predicted 3 an d 6 weeks survival with sensitivity 75 and 76% and specificity 84 and 78%, respectively. On the test populations, whether patients survived for 3 and 6 weeks or not was predicted with sensitivity 85 and 79% and specificity 84 and 72%, respectively. Conclusion: Whether or not patients live for 3 and 6 weeks can be acceptabl y predicted by this simple classification.