Tammemagi et al evaluated patients with lung cancer and identified a number of clinical symptoms associated with an adverse outcome. These can help to identify a patient who may benefit from more aggressive management. The authors are from Henry Ford Health System in Detroit.
Adverse symptoms associated with advanced disease and/or reduced survival:
(1) hoarseness
(2) hemoptysis
(3) dyspnea
(4) noncardiac chest pain
(5) extrathoracic pain
(6) neurologic symptoms
(7) unexplained weight loss
(8) weakness/fatigue
The more of these symptoms that are present the more severe the patient's condition.
The Stage-Symptom Index (SSI) was developed based on:
(1) tumor stage (from I to IV)
(2) the number of adverse symptoms present
Parameter
Finding
Points
stage
Stage I
1
Stage II
2
Stage III
3
Stage IV
4
number of adverse symptoms
0
0
1
1
2 to 8
2
SSI =
= SUM(points for the 2 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the worse the prognosis for the patient.
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