Patients’ Signs and Symptoms

Certain of patients’ clinical signs and symptoms have been shown to be predictive of survival in patients with advanced illness (Feinstein 19661967Vigano 2000Hardy 1994Morita 1999Tamburini 1996).

From the advanced cancer literature, Vigano and colleagues examined 136 different variables from 22 studies and found that, after performance status, specific signs and symptoms were the next best predictors of patient survival (Vigano 2000).

The presence of:

  • dyspnea,
  • dysphagia,
  • weight loss,
  • xerostomia,
  • anorexia, and
  • cognitive impairment

had the most compelling evidence for independent association with patient survival in these studies.

The following table contains the range of median survivals for the various symptoms reported in univariate analyses from these and other studies.

Predictors of Survival with Advanced Cancer under Palliative Care

Index

Value

Median survival (d)

References

Karnofsky Performance Scale Status 10-20 7-16 3,6,14,16,27,28,35
30-40 8-50
50 50-90
Anorexia Present < 58 14,28,35
Confusion Present <38 28,35
Dysphagia Present <30 14
Dyspnea Present <30 14
Xerostomia Present <50 35
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