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Crit Rev Oncol Hematol. 2012 Oct;84(1):130-48. doi: 10.1016/j.critrevonc.2012.02.011. Epub 2012 Mar 31.

Symptoms tell it all: a systematic review of the value of symptom assessment to predict survival in advanced cancer patients.

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  • 1Department of Medical Oncology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.

Abstract

PURPOSE:

To determine the prognostic meaning of symptoms in patients with advanced cancer.

DESIGN:

Medline, Embase, Cochrane and Cinahl databases were systematically explored. The predicting symptoms were also evaluated in the three stages of palliative care: disease-directed palliation, symptom-oriented palliation and palliation in the terminal stage.

RESULTS:

Out of 3167 papers, forty-four papers satisfied all criteria. Confusion, anorexia, fatigue, cachexia, weight loss, cognitive impairment, drowsiness, dyspnea, dysphagia, dry mouth and depressed mood were associated with survival in ≥ 50% of the studies evaluating these symptoms. Multivariate analysis showed confusion, anorexia, fatigue, cachexia, weight loss, dyspnea and dysphagia as independent prognostic factors in 30-56% of the studies. In the stage of disease-directed palliation anorexia, cachexia, weight loss, dysphagia and pain and in the stage of symptom-oriented palliation confusion, fatigue, cachexia, weight loss, dyspnea, dysphagia and nausea were shown to be independent predictors of survival in >30% of the studies.

CONCLUSION:

Symptoms with independent predictive value are confusion, anorexia, fatigue, cachexia, weight loss, dyspnea and dysphagia. New insights are added by the variance between the three palliative stages.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

PMID:
22465016
[PubMed - indexed for MEDLINE]
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