Evidence map›Paper›PMID 40684136›Full record

ArticleBMC palliative care2025

Factors associated with ADL-defined disability-free survival among patients with advanced cancer in a palliative care setting: a retrospective cohort study.

Ryo Soeda, Michiyuki Kawakami, Kengo Nagashima, Tsuyoshi Harada, Takuya Yamaguchi, Yu Furukawa, Tetsuya Tsuji

Abstract read
In one paragraph

Article in BMC palliative care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ryo SoedaDepartment of Rehabilitation, Tsurumaki-Onsen Hospital, Hadano, Kanagawa, Japan.ORCID http://orcid.org/0000-0001-6726-8835
Michiyuki KawakamiDepartment of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, , Tokyo, Japan.
Kengo NagashimaBiostatistics Unit, Clinical and Translational Research Center, Keio University, Shinjuku, , Tokyo, Japan.ORCID http://orcid.org/0000-0003-4529-9045
Tsuyoshi HaradaDepartment of Rehabilitation Medicine, Keio University Graduate School, Shinjuku, Tokyo, Japan.ORCID http://orcid.org/0000-0003-4459-8262
Takuya YamaguchiDepartment of Rehabilitation, Tsurumaki-Onsen Hospital, Hadano, Kanagawa, Japan.
Yu FurukawaDepartment of Rehabilitation, Tsurumaki-Onsen Hospital, Hadano, Kanagawa, Japan.
Tetsuya TsujiDepartment of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, , Tokyo, Japan. t.tsuji@keio.jp.ORCID http://orcid.org/0000-0002-4728-9409

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDisability-free survival (DFS) focusing on essential activities of daily living (ADL) is a critical outcome for patients with advanced cancer receiving palliative care, yet remains underexplored. This study aimed to examine DFS for core ADL components (eating, toileting, and walking) in patients admitted to the palliative care unit (PCU) and to identify associated factors using a competing risk model. Understanding these factors may guide targeted interventions to preserve functional independence and enhance quality of life.

methodsThis retrospective cohort study included advanced cancer patients admitted to the PCU between August 2018 and September 2022, excluding those discharged home. The primary endpoint was DFS, defined as the period from admission to an event resulting in a Functional Independence Measure (FIM™) score below 6 in eating, toileting, or walking. FIM™ is a widely used tool for assessing functional independence across multiple domains. DFS was estimated using a competing risk model to account for death as a competing event, and Fine–Gray regression analysis was conducted to identify factors associated with DFS.

resultsA total of 143, 48, and 46 patients were analyzed for eating, toileting, and walking, respectively. The median DFS (95% confidence interval) was 4 (3–5) weeks for eating, 3.5 (3–6) weeks for toileting, and 3 (2–6) weeks for walking. Cognitive function (FIM™ cognitive items) and the cachexia (modified Glasgow Prognostic Score) at admission were commonly associated with DFS. Neutrophil-to-lymphocyte ratio was specifically associated with DFS for eating, and bone and liver metastases were associated with DFS for toileting and walking.

conclusionsMonitoring ADL-defined DFS and key factors such as cognitive function and inflammation-nutritional status may enable timely interventions, optimize care strategies, and support quality of life for patients with advanced cancer in palliative care settings. Future studies could explore prospective validation of these findings and investigate whether early interventions targeting these factors can extend disability-free survival. In addition, integrating rehabilitation strategies and routine cognitive assessments may further enhance the benefits of individualized care in this population.

Indexed as

Activities of Daily LivingNeoplasmsPalliative CareAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedQuality of LifeRetrospective StudiesAdvanced cancerDisability-free survivalEatingPalliative care unitToiletingWalking

Identifiers

PMID40684136
PMCPMC12275397

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.