{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:47:08Z","timestamp":1791740828995,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Previous studies have discussed the effectiveness of the Karnofsky Performance Scale (KPS), Palliative Performance Scale (PPS), Palliative Prognostic Index (PPI), and Delirium\u2010Palliative Prognostic Score (D\u2010PaP) in predicting the survival of patients with terminal\u2010stage tumors, but their effectiveness in the Chinese terminal\u2010stage tumor population still needs to be explored. Therefore, we conducted this prospective cohort study to investigate the applicability of KPS, PPS, PPI, and D\u2010PaP in predicting survival in Chinese patients with terminal\u2010stage tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a prospective cohort study that collected data from 449 terminal\u2010stage tumor patients across four medical institutions in China from January to December 2024. The feasibility of using KPS, PPS, PPI, and D\u2010PaP to predict the 7\u2010day and 30\u2010day survival of terminal\u2010stage tumor patients was discussed through ROC curves. Kaplan\u2013Meier survival curves were used to examine the survival differences of terminal\u2010stage tumor patients using four survival prediction tools with new cut\u2010off values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study ultimately included 449 patients with terminal\u2010stage tumors. For the prediction of 30\u2010day survival, the area under the ROC curve of KPS, PPI, PPS, and D\u2010PaP was 0.842, 0.749, 0.778, and 0.898, respectively. In our study cohort, the optimal cut\u2010off values were 25, 3, 35, and 9.25. Their corresponding sensitivity was 86.3%, 92.3%, 77.7%, and 76.0%, while their specificity was 69.7%, 44.4%, 67.7%, and 93.9%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results of this multicenter cohort analysis reveal that in terminal\u2010stage tumor patients in China, KPS, PPS, PPI, and D\u2010PaP are all effective for predicting survival. Specifically, D\u2010PaP is more applicable for predicting 30\u2010day survival. Although D\u2010PaP showed the most significant predictive power, its accuracy in predicting 7\u2010day and 30\u2010day survival outcomes was not significantly superior to that of experienced palliative care professionals. Therefore, future research still needs to develop or update scoring tools with better predictive performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72283","type":"journal-article","created":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:45:07Z","timestamp":1791740707000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Survival Prognostic Tools in Terminal\u2010Stage Tumor Patients: A Multicenter Prospective Cohort Study"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9097-9536","authenticated-orcid":false,"given":"Ziluo","family":"Cheng","sequence":"first","affiliation":[{"name":"Thoracic Surgery Unit Jiangsu Cancer Hospital  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Jin","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Unit Jiangsu Cancer Hospital  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Mei","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Jiangsu Cancer Hospital  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pain Management Jiangsu Cancer Hospital  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"issue":"4","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.jpainsymman.2019.11.009","article-title":"Mapping Levels of Palliative Care Development in 198 Countries: The Situation in 2017","volume":"59","author":"Clark D.","year":"2020","journal-title":"Journal of Pain and Symptom Management"},{"issue":"4","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"e419","DOI":"10.1016\/j.jpainsymman.2021.12.015","article-title":"Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021","volume":"63","author":"Finkelstein E. 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