Utilidad del Palliative Performance Scale v2 para la estimación de supervivencia en enfermos con cáncer avanzado

Abstract

Objective1) to estimate the predictive value of the Palliative Performance Status Scale (PPS) for the prognosis of survival of patients with advanced cancer. 2) to clarify the profile and survival rate of a group of oncology patients admitted into a hospital palliative care unit. Material and methodA prospective longitudinal study was performed on a cohort of 157 patients with cancer and an expected survival rate of less than three months. Selection criteria: patients were excluded in situation of agony with imminent death or their PPSv2 at admission was equal to or higher than 80%. Variables used were: age, sex, type of tumour, location and extension of cancer, PPSv2 on admission and survival time. Study setting: palliative care unit of a university hospital. ResultsThe study included 157 patients consecutively admitted to our unit. Mean age was 69.27±12.24 years, with a median of 71 years and a majority of males (61.8%). The most common cancer site was the respiratory system (20.4%). The mean and median of overall survival were 19.85 days (95% CI; 16.7-23.0) and 13 days (95% CI; 10.3-15.7). Due to their small number, all the cases with a PPSv2 ≥ 50% were analysed together. Of the whole study 73% of cases had a PPSv2 ‹ 30%, 16.6% had a PPSv2 of 40%, and 9.5% had a PPSv2 ≥ 50%. Median survival of patients with a PPSv2 of 10% was 6 days compared with 15 days for a PPSv2 of 30%, and 32 days for scores greater than 50%. ConclusionsThe PPS scale on admission proved to be a useful tool to evaluate the survival of patients on palliative care. The lowest scores having a clear association with the lowest survivals. Thus, the periodical determination of the PPSv2 can be a useful prognostic tool.