ArticlePloS one2017
A systematically structured review of biomarkers of dying in cancer patients in the last months of life; An exploration of the biology of dying.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Abdominal CT findings on the day of death in patients with solid organ malignancies.Abdominal radiology (New York) · 2026Article
- Machine learning decision tree models for multiclass classification of prognosis in patient undergoing palliative radiotherapy for bone metastases.Journal of applied clinical medical physics · 2026Article
- Factors influencing self-decision in withholding or withdrawal of life-sustaining treatments among older patients admitted to general hospital: A retrospective case-control study.Journal of Korean gerontological nursing · 2025Article
- Effects of environmental temperature on mortality in cancer patients in palliative care.BMC palliative care · 2025Article
- Urinary metabolite model to predict the dying process in lung cancer patients.Communications medicine · 2025Article
- Recognising dying in motor neurone disease: A scoping review.Palliative medicine · 2024Article
- GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer.International journal of molecular sciences · 2023Article
- Life-Sustaining Treatment Decision in Palliative Care Based on Electronic Health Records Analysis.Journal of clinical nursing · 2023Review
- Lessons for Understanding Central Nervous System HIV Reservoirs from the Last Gift Program.Current HIV/AIDS reports · 2022Review
- Identification of Digital Health Priorities for Palliative Care Research: Modified Delphi Study.JMIR aging · 2022Article
- Prognostic model for patients with advanced cancer using a combination of routine blood test values.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Palliative Care and COVID-19 Pandemic: Retrospective Study of Factors Associated With Infection and Death at an Oncological Palliative Care Reference Center.The American journal of hospice & palliative care · 2021Article
- Hypernatremia at admission predicts poor survival in patients with terminal cancer: a retrospective cohort study.BMC palliative care · 2020Article
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- Survival time after marked reduction in oral intake in terminally ill noncancer patients: A retrospective study.Journal of general and family medicine · 2020Article
- Article
- Well-Being at the End of Life.Annual review of sociology · 2019Article
- Translational Research in Oncology: Implications for Palliative Care.Indian journal of palliative careArticle
- Impact of Prognostic Nutritional Index on Terminal Cancer Patients.Indian journal of palliative careArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Neuberger review made a number of recommendations to improve end of life care, including research into the biology of dying. An important aspect of the biology of dying is the identification of biomarkers as indices of disease processes. Biomarkers have the potential to inform the current, limited understanding of the dying process and assist clinicians in recognising dying, in particular how to distinguish dying from reversible acute deterioration.
objectivesTo critically appraise the literature on biological factors that may be used as prognostic indicators in advanced cancer patients and to identify candidate biomarkers of the dying process that can be measured serially in cancer patients' bodily fluids.
methodsA systematically structured review was conducted using three electronic databases. A hand search of six peer-reviewed journals and conference abstracts was also conducted. Studies reporting prognostic biomarkers in cancer patients with a median survival of ≤90 days and post-mortem studies were included. Final levels of evidence and recommendations were made using the Evidence Based Medicine modified GRADE system.
results30 articles were included. Seven prognostic biological factors demonstrated Grade A evidence (lymphocyte count, white blood cell count, serum C-reactive protein, albumin, sodium, urea and alkaline phosphatase). An additional eleven prognostic factors were identified with Grade B evidence (platelet count, international normalised ratio, serum vitamin B12, prealbumin, bilirubin, cholesterol, aspartate aminotransferase, alanine transaminase, lactate dehydrogenase, pseudocholinesterase and urate). A number of biomarkers were specifically identified in the last two weeks of life but limitations exist. No post-mortem studies met the inclusion criteria.
conclusionThe biology of dying is an important area for future research, with the evidence focused on signs, symptoms and prognostic factors. This review identifies a number of common themes shared amongst advanced cancer patients and highlights candidate biomarkers which may be indicative of a common biological process to dying.
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