A combination of routine laboratory findings and vital signs can predict survival of advanced cancer patients without physician evaluation: a fractional polynomial model

Jun Hamano, Ayano Takeuchi, Takuhiro Yamaguchi, Mika Baba, Kengo Imai, Masayuki Ikenaga, Yoshihisa Matsumoto, Ryuichi Sekine, Takashi Yamaguchi, Takeshi Hirohashi, Tsukasa Tajima, Ryohei Tatara, Hiroaki Watanabe, Hiroyuki Otani, Hiroka Nagaoka, Masanori Mori, Yo Tei, Shuji Hiramoto, Tatsuya Morita

Research output: Contribution to journalArticle

Abstract

Introduction: There have been no reports about predicting survival of patients with advanced cancer constructed entirely with objective variables. We aimed to develop a prognostic model based on laboratory findings and vital signs using a fractional polynomial (FP) model. Methods: A multicentre prospective cohort study was conducted at 58 specialist palliative care services in Japan from September 2012 to April 2014. Eligible patients were older than 20 years and had advanced cancer. We developed models for predicting 7-day, 14-day, 30-day, 56-day and 90-day survival by using the FP modelling method. Results: Data from 1039 patients were analysed to develop each prognostic model (Objective Prognostic Index for advanced cancer [OPI-AC]). All models included the heart rate, urea and albumin, while some models included the respiratory rate, creatinine, C-reactive protein, lymphocyte count, neutrophil count, total bilirubin, lactate dehydrogenase and platelet/lymphocyte ratio. The area under the curve was 0.77, 0.81, 0.90, 0.90 and 0.92 for the 7-day, 14-day, 30-day, 56-day and 90-day model, respectively. The accuracy of the OPI-AC predicting 30-day, 56-day and 90-day survival was significantly higher than that of the Palliative Prognostic Score or the Prognosis in Palliative Care Study model, which are based on a combination of symptoms and physician estimation. Conclusion: We developed highly accurate prognostic indexes for predicting the survival of patients with advanced cancer from objective variables alone, which may be useful for end-of-life management. The FP modelling method could be promising for developing other prognostic models in future research.

Original languageEnglish
Pages (from-to)50-60
Number of pages11
JournalEuropean Journal of Cancer
Volume105
DOIs
Publication statusPublished - 2018 Dec 1

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Vital Signs
Statistical Models
Physicians
Survival
Neoplasms
Palliative Care
Lymphocyte Count
Respiratory Rate
L-Lactate Dehydrogenase
Bilirubin
C-Reactive Protein
Area Under Curve
Urea
Albumins
Creatinine
Japan
Neutrophils
Cohort Studies
Blood Platelets
Heart Rate

Keywords

  • Fractional polynomial model
  • Laboratory findings
  • Prognostic index
  • Vital signs

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

A combination of routine laboratory findings and vital signs can predict survival of advanced cancer patients without physician evaluation : a fractional polynomial model. / Hamano, Jun; Takeuchi, Ayano; Yamaguchi, Takuhiro; Baba, Mika; Imai, Kengo; Ikenaga, Masayuki; Matsumoto, Yoshihisa; Sekine, Ryuichi; Yamaguchi, Takashi; Hirohashi, Takeshi; Tajima, Tsukasa; Tatara, Ryohei; Watanabe, Hiroaki; Otani, Hiroyuki; Nagaoka, Hiroka; Mori, Masanori; Tei, Yo; Hiramoto, Shuji; Morita, Tatsuya.

In: European Journal of Cancer, Vol. 105, 01.12.2018, p. 50-60.

Research output: Contribution to journalArticle

Hamano, J, Takeuchi, A, Yamaguchi, T, Baba, M, Imai, K, Ikenaga, M, Matsumoto, Y, Sekine, R, Yamaguchi, T, Hirohashi, T, Tajima, T, Tatara, R, Watanabe, H, Otani, H, Nagaoka, H, Mori, M, Tei, Y, Hiramoto, S & Morita, T 2018, 'A combination of routine laboratory findings and vital signs can predict survival of advanced cancer patients without physician evaluation: a fractional polynomial model', European Journal of Cancer, vol. 105, pp. 50-60. https://doi.org/10.1016/j.ejca.2018.09.037
Hamano, Jun ; Takeuchi, Ayano ; Yamaguchi, Takuhiro ; Baba, Mika ; Imai, Kengo ; Ikenaga, Masayuki ; Matsumoto, Yoshihisa ; Sekine, Ryuichi ; Yamaguchi, Takashi ; Hirohashi, Takeshi ; Tajima, Tsukasa ; Tatara, Ryohei ; Watanabe, Hiroaki ; Otani, Hiroyuki ; Nagaoka, Hiroka ; Mori, Masanori ; Tei, Yo ; Hiramoto, Shuji ; Morita, Tatsuya. / A combination of routine laboratory findings and vital signs can predict survival of advanced cancer patients without physician evaluation : a fractional polynomial model. In: European Journal of Cancer. 2018 ; Vol. 105. pp. 50-60.
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T1 - A combination of routine laboratory findings and vital signs can predict survival of advanced cancer patients without physician evaluation

T2 - a fractional polynomial model

AU - Hamano, Jun

AU - Takeuchi, Ayano

AU - Yamaguchi, Takuhiro

AU - Baba, Mika

AU - Imai, Kengo

AU - Ikenaga, Masayuki

AU - Matsumoto, Yoshihisa

AU - Sekine, Ryuichi

AU - Yamaguchi, Takashi

AU - Hirohashi, Takeshi

AU - Tajima, Tsukasa

AU - Tatara, Ryohei

AU - Watanabe, Hiroaki

AU - Otani, Hiroyuki

AU - Nagaoka, Hiroka

AU - Mori, Masanori

AU - Tei, Yo

AU - Hiramoto, Shuji

AU - Morita, Tatsuya

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Introduction: There have been no reports about predicting survival of patients with advanced cancer constructed entirely with objective variables. We aimed to develop a prognostic model based on laboratory findings and vital signs using a fractional polynomial (FP) model. Methods: A multicentre prospective cohort study was conducted at 58 specialist palliative care services in Japan from September 2012 to April 2014. Eligible patients were older than 20 years and had advanced cancer. We developed models for predicting 7-day, 14-day, 30-day, 56-day and 90-day survival by using the FP modelling method. Results: Data from 1039 patients were analysed to develop each prognostic model (Objective Prognostic Index for advanced cancer [OPI-AC]). All models included the heart rate, urea and albumin, while some models included the respiratory rate, creatinine, C-reactive protein, lymphocyte count, neutrophil count, total bilirubin, lactate dehydrogenase and platelet/lymphocyte ratio. The area under the curve was 0.77, 0.81, 0.90, 0.90 and 0.92 for the 7-day, 14-day, 30-day, 56-day and 90-day model, respectively. The accuracy of the OPI-AC predicting 30-day, 56-day and 90-day survival was significantly higher than that of the Palliative Prognostic Score or the Prognosis in Palliative Care Study model, which are based on a combination of symptoms and physician estimation. Conclusion: We developed highly accurate prognostic indexes for predicting the survival of patients with advanced cancer from objective variables alone, which may be useful for end-of-life management. The FP modelling method could be promising for developing other prognostic models in future research.

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KW - Laboratory findings

KW - Prognostic index

KW - Vital signs

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