Palliative Prognostic Score
Estimates survival in advanced cancer using clinical and laboratory variables.
When to use
Patients with advanced cancer in palliative care, to support survival estimation.
Pearls and pitfalls
- PaP combines dyspnea, anorexia, Karnofsky, clinical prediction, white cells and lymphocytes.
- Clinical prediction of survival is the heaviest item, worth up to 8.5 points.
- Karnofsky between 30 and 40 adds no points in this score; only 10 to 20 adds 2.5.
- The score was derived to estimate survival in weeks and does not replace clinical assessment.
- Reassess over time; the trajectory may be more informative than a single measurement.
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Formula
Add dyspnea (1), anorexia (1.5), Karnofsky (0 or 2.5), clinical prediction (0 to 8.5), white cells (0 to 1.5) and lymphocytes (0 to 2.5); total from 0 to 17.5.
Evidence
Score derived and validated in terminally ill cancer patients to stratify survival into risk groups.
References
- Pirovano M, Maltoni M, Nanni O, et al. A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. J Pain Symptom Manage. 1999;17(4):231-239. doi:10.1016/S0885-3924(98)00145-6
Frequently asked questions
What is Palliative Prognostic Score?
Estimates survival in advanced cancer using clinical and laboratory variables. Patients with advanced cancer in palliative care, to support survival estimation.
How is the result calculated?
Add dyspnea (1), anorexia (1.5), Karnofsky (0 or 2.5), clinical prediction (0 to 8.5), white cells (0 to 1.5) and lymphocytes (0 to 2.5); total from 0 to 17.5.
How should the result be interpreted?
Score derived and validated in terminally ill cancer patients to stratify survival into risk groups.
What are the sources?
Pirovano M, Maltoni M, Nanni O, et al. A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. J Pain Symptom Manage. 1999;17(4):231-239.