The knowledge and use of prognostic scales by oncologists and palliative care specialists in adult patients with advanced cancer: A French national survey (oncoprono study)

Background: Prognostic scales exist to estimate patient survival in advanced cancer. There are no studies evaluating their use and practical utility. Aim: To evaluate the proportion of respondents who had knowledge of these prognostic scales. Methods: A descriptive national cross-sectional study was conducted between September 2019 and September 2020. An online questionnaire was prepared using international literature and sent to French oncologists and palliative care physicians. Results: Participation rate was 9.6% (325 responses for 3 408 respondents), with 38% (175 responses for 454 respondents) for palliative care specialists and 4% (119 responses for 2 954 respondents) for oncologists. After sorting the respondents out of the inclusion criteria, 294 questionnaires were analysed. 63.6% (n= 187) had no or partial knowledge of prognostic scales. Palliative care specialists had better knowledge of those scales than oncologists (42.3% (n= 74) vs 27.8% (n= 33), p = 0.015). The Palliative Performance Status (PPS) and the Pronopall Scale were the best-known (respectively 51.4% (n= 55) and 65.4% (n= 70)) and the most widely used (35% (n=28) and 60% (n= 48)). Improving training on those scales was requested by 85.4% (n= 251) of participants. 72.8% (n= 214) did not use them. The lack of formation and consensus about the scale to use are the principal brakes for using. Conclusion: This is the first national study on this topic. Due to the COVID-19 epidemic and a lack of research network between oncology and palliative care in France, the participation rate is a major limitation. To our respondents, there is a need for more information and teaching about prognostic scales in advanced cancer. So improvement concerning research network and teaching are requested. Furthermore, identifying circumstances in which prognostic scales should be used in real practice and clear international guidelines are needed.