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Hartsell WF , Desilvio M , Bruner DW , Scarantino C , Ivker R , Roach M , Suh J , Demas WF , Movsas B , Petersen IA , Konski AA
Can physicians accurately predict survival time in patients with metastatic cancer? Analysis of RTOG 97-14
Journal of Palliative Medicine. 2008 Jun;11(5) :723-728
PMID: ISI:000257535100014   
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Purpose: To determine if physician prediction of survival duration (PSD) is accurate for patients with metastatic breast or prostate cancer. Methods: Radiation Therapy Oncology Group 9714 (RTOG 9714) was a randomized comparison of radiotherapy schedules for treatment of bone metastases. The treating physician assigned a baseline Karnofsky Performance Score (KPS) and predicted survival duration at study entry. Patients completed the Functional Assessment of Cancer Therapy (FACT). These three were compared to actual survival time. Results: Eight hundred ninety-eight patients were eligible and analyzable. Actual median survival was 9.3 months. The median PSD was 12 months. PSD, KPS, and FACT were all moderately correlated with actual survival. Patients with higher KPS had a longer survival time (882 patients, Spearman's rho = 0.259, p < 0.0001). The median survival of the 618 expired patients is 6.5 months (PSD was 12 months). The PSD was within 1 month of actual survival in 61 (10%), with 177 (29%) patients surviving more than 1 month longer than predicted and 375 (61%) surviving more than 1 month less than predicted. A univariate analysis of actual overall survival was performed, dividing the PSD into 4 groups. For predicted survivals of 6 months or less, less than 6 to less than 12 months, 12 months, and more than 12 months, median actual survivals were 7.0, 7.2, 9.7. and 13.5 months (p < 0.0001). Conclusions: KPS, FACT scores, and PSD all are correlated with actual survival. Physicians on this study were able to predict which patients would have longer survival times, although prediction of survival was optimistic compared to actual survival by an average of 3 months.
ISI Document Delivery No.: 324RG Times Cited: 0 Cited Reference Count: 9 Cited References: CELLA DF, 1993, J CLIN ONCOL, V11, P570 CHOW E, 2005, INT J RADIAT ONCOL, V61, P870 COX DR, 1972, J R STAT SOC B, V34, P187 GLARE P, 2003, BRIT MED J, V327, P195 HARTSELL WF, 2005, J NATL CANCER I, V97, P798 KAPLAN EL, 1958, J AM STAT ASSOC, V53, P457 MANTEL N, 1966, CANCER CHEMOTHERAPY, V50, P163 STEINHAUSER KE, 2000, JAMA-J AM MED ASSOC, V284, P2476 VIGANO A, 2000, PALLIATIVE MED, V14, P363 Hartsell, William F. Desilvio, Michelle Bruner, Deborah Watkins Scarantino, Charles Ivker, Robert Roach, Mack, III Suh, John Demas, William F. Movsas, Benjamin Petersen, Ivy A. Konski, Andre A. MARY ANN LIEBERT INC; 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA