VALIDATION Palliative prognostic SCORE (SCORE PAP) IN PATIENTS CANCER METASTASIS IN STADIUM DR Sardjito
ABSTRACT: Background. The mortality burden of cancer continues to increase in developing countries, most likely because of a late stage at diagnosis. Identify the terminal stage is important in patients with advanced cancer because in patients with terminal cancer, the therapy is no longer aggressive. Palliative prognostic score (PaP score) is a scoring system to predict the probability of survival within 30 days in patients with advanced cancer. PaP score divided the heterogeneous patient sample into three iso-prognostic groups related to the chance of surviving 30-days : Group A, score: 0 to 5.5 (the probability of survival within 30 days > 70%); Group B, score: 6-11 (the probability of survival in 30 days 30-70%) and group C, the score: 11.5 to 17.5 (the probability of survival in 30 days <30%). Objectives. The aim of this study was to validate and to evaluate the predictive accuracy of the palliative prognostic (PaP score) to predict 30-day survival in patients with metastatic cancers in RSUP Dr Sardjito Yogyakarta. Methods. The design of this prognostic study was cohort, include patients with metastatic cancers were visited in clinic Tulip, inpatient and outpatient care in the Dr Sardjito hospital during May 2015 to May 2016. The PaP score was calculated in 159 consecutive patients with metastatic cancers. The positive predictive value of the PaP score was evaluated and survival analysis was performed to compare the survival of the three prognostic group. Results. PaP score was tested on 159 subjects with overall median survival was 90 days, 76 patients categorized into group A, 22 patients into group B and 61 patients into group C. The 30-day survival probability was 98,7% for group A (median survival could not be assessed), 63,6 % probability of 30-day survival for group B with median survival was 35 days and for group C with 3,3% probability of 30-day and median survival was 6 days. These survival differences were highly significant (log-rank test of trends, X 2 =203,97; P<0,0001). Positive predictive value of PaP score in predicting 30-day mortality was 96.7% with an accuracy of PaP score was 93.1%. Conclusion. PaP score is a valid test tool in determining prognosis in patients with metastatic cancers with high accuracy and precision in predicting survival within 30 days.
