Prognostic Value of Performance Status, Albumin, and CRP in Last-Line Chemotherapy for Pancreatic vs. Other Gastrointestinal Cancers—Simple Tools Matter
Patients with advanced gastrointestinal cancers often receive chemotherapy near the end of life (EoL), raising concerns about overtreatment. The PALLiON trial, a cluster-randomized trial, assessed the impact of a complex intervention on frequency of EoL treatment; the intervention involved palliativ...
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| Language: | English |
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MDPI AG
2024-09-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/31/9/404 |
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| author | Arne Westgaard Aleksandra Pirnat Marianne Jensen Hjermstad Nina Aass Stein Kaasa Olav Faisal Dajani |
| author_facet | Arne Westgaard Aleksandra Pirnat Marianne Jensen Hjermstad Nina Aass Stein Kaasa Olav Faisal Dajani |
| author_sort | Arne Westgaard |
| collection | DOAJ |
| description | Patients with advanced gastrointestinal cancers often receive chemotherapy near the end of life (EoL), raising concerns about overtreatment. The PALLiON trial, a cluster-randomized trial, assessed the impact of a complex intervention on frequency of EoL treatment; the intervention involved palliative care referrals and the use of PROMs. The present secondary analysis evaluated the prognostic value of baseline performance status (PS), albumin (alb), C-reactive protein (CRP), and body mass index (BMI) for overall survival, comparing pancreatic (PAN, n = 189) vs. other gastrointestinal cancer patients (GI, n = 286). Baseline PS, alb, CRP, mGPS (modified Glasgow prognostic score), and BMI were analyzed using Cox regression. Adjusted for age, sex, and hospital size, PS ≥ 2 and alb < 35 g/L predicted shorter survival in both PAN and GI cancers, while CRP > 10 predicted shorter survival only in GI cancers. In PAN, PS ≥ 2 predicted a 78.4% higher probability of shorter survival, and mGPS 2 predicted a 68.7% higher probability. In GI, mGPS 2 predicted a 70.8% higher probability, whereas PS was not significant. BMI did not improve predictive models. PS ≥ 2 and low albumin are strong predictors of short survival in PAN, whereas increased CRP and low albumin (mGPS 2) are predictors in GI. |
| format | Article |
| id | doaj-art-a6b511c2373d4fb499515a43a4d5b2e9 |
| institution | OA Journals |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-a6b511c2373d4fb499515a43a4d5b2e92025-08-20T01:55:22ZengMDPI AGCurrent Oncology1198-00521718-77292024-09-013195462547110.3390/curroncol31090404Prognostic Value of Performance Status, Albumin, and CRP in Last-Line Chemotherapy for Pancreatic vs. Other Gastrointestinal Cancers—Simple Tools MatterArne Westgaard0Aleksandra Pirnat1Marianne Jensen Hjermstad2Nina Aass3Stein Kaasa4Olav Faisal Dajani5Department of Oncology, Oslo University Hospital, 0424 Oslo, NorwayDepartment of Oncology, Oslo University Hospital, 0424 Oslo, NorwayDepartment of Oncology, Oslo University Hospital, 0424 Oslo, NorwayDepartment of Oncology, Oslo University Hospital, 0424 Oslo, NorwayDepartment of Oncology, Oslo University Hospital, 0424 Oslo, NorwayDepartment of Oncology, Oslo University Hospital, 0424 Oslo, NorwayPatients with advanced gastrointestinal cancers often receive chemotherapy near the end of life (EoL), raising concerns about overtreatment. The PALLiON trial, a cluster-randomized trial, assessed the impact of a complex intervention on frequency of EoL treatment; the intervention involved palliative care referrals and the use of PROMs. The present secondary analysis evaluated the prognostic value of baseline performance status (PS), albumin (alb), C-reactive protein (CRP), and body mass index (BMI) for overall survival, comparing pancreatic (PAN, n = 189) vs. other gastrointestinal cancer patients (GI, n = 286). Baseline PS, alb, CRP, mGPS (modified Glasgow prognostic score), and BMI were analyzed using Cox regression. Adjusted for age, sex, and hospital size, PS ≥ 2 and alb < 35 g/L predicted shorter survival in both PAN and GI cancers, while CRP > 10 predicted shorter survival only in GI cancers. In PAN, PS ≥ 2 predicted a 78.4% higher probability of shorter survival, and mGPS 2 predicted a 68.7% higher probability. In GI, mGPS 2 predicted a 70.8% higher probability, whereas PS was not significant. BMI did not improve predictive models. PS ≥ 2 and low albumin are strong predictors of short survival in PAN, whereas increased CRP and low albumin (mGPS 2) are predictors in GI.https://www.mdpi.com/1718-7729/31/9/404pancreatic adenocarcinomagastrointestinal cancerend-of-life chemotherapypalliative care |
| spellingShingle | Arne Westgaard Aleksandra Pirnat Marianne Jensen Hjermstad Nina Aass Stein Kaasa Olav Faisal Dajani Prognostic Value of Performance Status, Albumin, and CRP in Last-Line Chemotherapy for Pancreatic vs. Other Gastrointestinal Cancers—Simple Tools Matter Current Oncology pancreatic adenocarcinoma gastrointestinal cancer end-of-life chemotherapy palliative care |
| title | Prognostic Value of Performance Status, Albumin, and CRP in Last-Line Chemotherapy for Pancreatic vs. Other Gastrointestinal Cancers—Simple Tools Matter |
| title_full | Prognostic Value of Performance Status, Albumin, and CRP in Last-Line Chemotherapy for Pancreatic vs. Other Gastrointestinal Cancers—Simple Tools Matter |
| title_fullStr | Prognostic Value of Performance Status, Albumin, and CRP in Last-Line Chemotherapy for Pancreatic vs. Other Gastrointestinal Cancers—Simple Tools Matter |
| title_full_unstemmed | Prognostic Value of Performance Status, Albumin, and CRP in Last-Line Chemotherapy for Pancreatic vs. Other Gastrointestinal Cancers—Simple Tools Matter |
| title_short | Prognostic Value of Performance Status, Albumin, and CRP in Last-Line Chemotherapy for Pancreatic vs. Other Gastrointestinal Cancers—Simple Tools Matter |
| title_sort | prognostic value of performance status albumin and crp in last line chemotherapy for pancreatic vs other gastrointestinal cancers simple tools matter |
| topic | pancreatic adenocarcinoma gastrointestinal cancer end-of-life chemotherapy palliative care |
| url | https://www.mdpi.com/1718-7729/31/9/404 |
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