Prospective Comparison of Prognostic Scores in Palliative Care Cancer Populations

Purpose. Predicting prognosis in advanced cancer aids physicians in clinical decision making and can help patients and their families to prepare for the time ahead. Materials and Methods. This multicenter, observational, prospective, nonrandomized population-based study evaluated life span prediction of four prognostic scores used in palliative care: the original Palliative Prognostic Score (PaP Score), a variant of PaP Score including delirium (DPaP Score), the Palliative Performance Scale, and the Palliative Prognostic Index. Results. A total of 549 patients were enrolled onto the study. Median survival of the entire group was 22 days (95% confidence intervals [95% CI] 19–24). All four prognostic models discriminated well between groups of patients with differentsurvivalprobabilities.Log-ranktestswereallhighly significant (p < .0001). The PaP and D-PaP scores were the most accurate, with a C index of 0.72 (95% CI 0.70–0.73) and 0.73 (95% CI 0.71–0.74), respectively. Conclusion. It can be confirmed that all four prognostic scores used in palliative care studies accurately identify classesofpatientswithdifferentsurvivalprobabilities.The PaP Score has been extensively validated and shows high accuracy and reproducibility in different settings. The Oncologist 2012;17:446–454