The Prediction of survival in patients with locally advanced or metastatic cancer, during palliative treatment or palliative care, is mandatory. The aim of our study was to evaluate the Palliative Prognostic Index (PPI) in the assessment of overall survival (OS) of patients with locally advanced or metastatic cancer.
This is a retrospective study including patients diagnosed and treated for locally advanced or metastatic cancer at the department of medical oncology in Sfax in 2020. These patients should have a performance status (PS) ≥2 and poor prognosis (central nervous system cancers (CNS), lung cancer, hepatocarcinoma, oesophageal cancer, pancreatic cancer and gastric cancer).
Thirty patients were included. The median age was 57. Tumour locations were as follows: lung in 40%, CNS in 30%, stomach in 17%, pancreas 7%, oesophagus in 3%, and hepatocarcinoma in 3%. The tumour stage was metastatic in 63% of cases. 33% of patients had ≥3 metastases. Metastatic brain localization was present in 32%. Current treatment was based on palliative chemotherapy in 47% of cases, palliative radiotherapy in 13% of cases and palliative care in 40%. PS 2 represented 83% of cases. The OS estimations using PPI were equal to 90 days 17%, 61 days in 27% and 12 days in 57%. Median real OS was equal to 274 days. The difference was significant comparing the survival estimation using PPI and the real OS (p=0.0001). Subgroup analysis showed a significant difference of the PPI in case of PS≥3 and metastatic disease.
In contrast to the data of the literature that validated the role of PPI score in the estimation of survival in locally advanced and metastatic cancers, in our study this score seems to underestimate survival in these patients. It may be more suitable to apply it for patients with a PS≥3 and metastatic stage.