Chow et al developed 2 models for predicting survival for a patient with advanced cancer. This can help a clinician to provide a reasonable estimates of survival for the patient and family. The authors are from Odetta Cancer Centre, Sunnybrook Health Sciences Centre, Princess Margaret Hospital and the University of Toronto.
Patient selection: advanced cancer, with distant metastases
Parameters:
(1) primary site for the cancer
(2) Karnofsky performance scale (KPS)
(3) metastases
Models:
(1) number of risk factors
(2) partial score method
|
Parameter |
Finding |
Points |
|
primary site |
breast |
0 |
|
|
non-breast |
1 |
|
Karnofsky performance scale |
> 60 |
0 |
|
|
<= 60 |
1 |
|
metastasis |
bone only |
1 |
|
|
other |
0 |
where:
• Metastases may relate to distant metastases (M status of TNM staging) rather than to locoregional lymph node involvement.
total number of risk factors =
= SUM(points for the 3 parameters)
|
Parameter |
Finding |
Points |
|
primary site |
breast |
0 |
|
|
prostate |
2 |
|
|
lung |
3 |
|
|
other |
3 |
|
Karnofsky performance scale |
> 60 |
0 |
|
|
<= 60 |
3 |
|
metastasis |
bone only |
0 |
|
|
other |
2 |
total partial score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum for both scores: 0
• maximum number of risk factors: 3
• maximum partial score: 8
• The higher the scores the worse the prognosis.
• The model using the number of risk factors was preferred since it is simpler.
|
Number of Risk Factors |
Median Survival |
|
0 or 1 |
55 to 64 weeks |
|
2 |
19 to 28 weeks |
|
3 |
9 to 10 weeks |
|
Total for Partial Score |
Median Survival |
|
0 to 4 |
53 to 64 weeks |
|
5 |
21 to 29 weeks |
|
6, 7 or 8 |
10 or 11 weeks |
Purpose: To predict survival for a patient with advanced cancer using the models of Chow et al.
Specialty: Hematology Oncology, Surgery, general
Objective: risk factors, clinical diagnosis, including family history for genetics, criteria for diagnosis, severity, prognosis, stage, complications, end-of-life, palliative care
ICD-10: C80,
