Prognostic evaluation in patients with advanced cancer in the last months of life: ESMO Clinical Practice Guideline ☆

ESMO Open · 14 authors, 17 centres

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TL;DR

This guideline reviews evidence for prognostic tools for patients with advanced incurable cancer in their final months of life. It finds good evidence for certain individual prognostic factors, like performance status, and some physical signs for predicting imminent death, but notes limited data on multivariable models for those receiving disease-modifying therapy.

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They caution that factors like performance status may be temporarily affected by therapy. For patients who are imminently dying, studies suggest physical signs and predictive models may inform identification with >80% accuracy, though more validation is needed.

STUDY TYPE

guidelines

SPECIALTY

oncology

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10242351

Prognostic evaluation in patients with advanced cancer in the last months of life: ESMO Clinical Practice Guideline ☆

ESMO Open

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ABSTRACT

Highlights • This ESMO Clinical Practice Guideline provides key recommendations for using prognostic estimates in advanced cancer. • The guideline covers recommendations for patients with cancer and an expected survival of months or less. • An algorithm for use of clinical predictions, prognostic factors and multivariable risk prediction models is presented. • The author group encompasses a multidisciplinary group of experts from different institutions in Europe, USA and Asia. • Recommendations are based on available scientific data and the authors’ collective expert opinion. Key words: advanced cancer, ESMO Clinical Practice Guideline, palliative care, prognostic factors, risk prediction models

CITATION EXPORT

P Stone, P Buckle, R Dolan et al.. Prognostic evaluation in patients with advanced cancer in the last months of life: ESMO Clinical Practice Guideline☆. ESMO Open. (2023). https://doi.org/10.1016/j.esmoop.2023.101195

AUTHORS

14 · 17 CENTRES

P Stone, P Buckle, R Dolan, J Feliu, D Hui, BJA Laird, M Maltoni, S Moine, T Morita, M Nabal, V Vickerstaff, N White, D Santini, CI Ripamonti

1Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
2Palliative Care Team, Central and North West London NHS Trust, London, UK
3Marie Curie Charity, London, UK
4Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
5Department of Medical Oncology, La Paz University Hospital, IdiPAZ, CIBERONC, Cátedra UAM-AMGEN, Madrid, Spain
6Departments of Palliative Care, Rehabilitation and Integrative Medicine, Houston, USA
7General Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
8Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital, Edinburgh, UK
9St Columba’s Hospice Care, Edinburgh, UK
10Medical Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
11Department of Specialised, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy
12Health Education and Practices Laboratory (LEPS EA3412), University Paris Sorbonne Paris Cité, Bobigny, Paris, France
13Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan
14Palliative Care Supportive Team, Hospital Universitario Arnau de Vilanova, Lleida, Spain
15Research Department of Primary Care and Population Health, University College London, London, UK
16UOC Oncologia Medica Territoriale, La Sapienza University of Rome, Polo Pontino, Rome, Italy
17Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy