Seve et al reported prognostic factors for a patient with a carcinoma of unknown primary site. These can help identify a patient who may benefit from more aggressive management. The authors are from Hospices Civils de Lyon (Lyon, France), University of Alberta (Edmonton), Centre Leon Berard (Lyon) and Claude Bernard University (Lyon).
Parameters:
(1) WHO (ECOG) performance scale
(2) comorbidity (as measured with the Adult Comorbidity Evaluation 27)
(3) liver metastases
(4) serum LDH
(5) absolute lymphocyte count
(6) serum albumin
|
Parameter |
Finding |
Points |
|
performance scale |
0 or 1 |
0 |
|
|
2, 3 or 4 |
1 |
|
comorbidity |
none, mild or moderate |
0 |
|
|
severe |
1 |
|
liver metastases |
absent |
0 |
|
|
present |
1 |
|
serum LDH |
normal |
0 |
|
|
elevated (> ULN) |
1 |
|
absolute lymphocyte count |
>= 700 per µL |
0 |
|
|
< 700 per µL (lymphopenia) |
1 |
|
serum albumin |
normal |
0 |
|
|
decreased (< LLN) |
1 |
where:
• ULN = upper limit of normal; LLN = lower limit of normal
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the worse the prognosis.
The authors also proposed a simple risk stratification system based on serum albumin and liver metastases.
|
Serum Albumin |
Liver Metastases |
Risk Group |
Median Survival |
|
normal |
none |
good |
371 days |
|
low |
none |
poor |
103 days |
|
normal |
present |
poor |
103 days |
|
low |
present |
poor |
103 days |
Purpose: To evaluate a patient with a carcinoma of unknown primary site using the prognostic factors reported by Seve et al.
Specialty: Hematology Oncology, Surgery, general
Objective: risk factors, selection
ICD-10: C80.9,
