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Research Article

Prognostication in palliative cancer care: Both probabilities and uncertainties must be taken into account

Erik Torbjørn Løhre
1,2,3*
Ragnhild Hansdatter Habberstad
1
Tora Skeidsvoll Solheim
1,2
Pål Klepstad
4,5
Gunnhild Jakobsen
1,6
Morten Thronæs
1,2,3

1 Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim

2 Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU–Norwegian University of Science and Technology, Trondheim

3 Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen

4 Clinic of Anesthesiology and Intensive Care Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim

5 Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU–Norwegian University of Science and Technology, Trondheim

6 Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU–Norwegian University of Science and Technology, Trondheim



Tumor Discovery 2025, 4(3),46-57; https://doi.org/10.36922/td.8576
Submitted17 Jan 2025
Revised01 May 2025
Accepted14 May 2025
Published02 Jul 2025
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Erik Torbjørn Løhre ,Ragnhild Hansdatter Habberstad ,Tora Skeidsvoll Solheim ,Pål Klepstad ,Gunnhild Jakobsen ,Morten Thronæs . (2025). <p>Prognostication in palliative cancer care: Both probabilities and uncertainties must be taken into account</p>. Tumor Discovery , 4(3), td8576. https://doi.org/10.36922/td.8576
Abstract

Prognosticating survival in palliative cancer patients has been a longstanding challenge. While different tools and approaches may ease prognostication, biological variability limits their accuracy. Assessment of physical status is important for prognostication, along with evaluating the degree of systemic inflammation and patient-reported symptom burden. The distribution of survival was examined among palliative cancer patients with different functional status (Eastern Cooperative Oncology Group Performance Status), inflammation-related markers (modified Glasgow prognostic score [mGPS]), and self-reported symptom intensities (the eleven-point numeric rating scale [0 – 10]). Physical status and biomarkers of systemic inflammatory responses yielded important prognostic information in patients with advanced cancer. Among 147 hospitalized patients, median survival was longer for those continuing anti-cancer treatment, those with better functional status, and those with normal levels of C-reactive protein and/or albumin. Regarding the functional status categories, patients with PS 2 exhibited the widest range of survival. All categories, except PS 4, included patients with actual survival of almost 1 year or more. In terms of inflammatory markers, the widest survival range was observed among patients with mGPS 0. All categories included patients with actual survival of more than half a year, and mGPS 0 and 1 included patients with survival of more than one and a half years. No statistically significant differences in survival were identified between patients with mild and higher intensities of the symptoms under investigation. A wide range of survival outcomes at the group level makes prognostication for individual patients particularly challenging.

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