Gauthier et al developed 2 simple prognostic scores for women with metastatic breast cancer and meningeal carcinomatosis. The authors are from the Institut Curie and University Paris.
Patient selection: meningeal carcinomatosis in a patient with breast cancer
Parameters:
(1) hormone receptor status
(2) WHO/ECOG performance status
(3) number of previous chemotherapy "lines" (probably courses)
(4) CSF concentration of Cyfra 21-1 (Cy =cytokeratin, fra = fragment, cytokeratin CK19 fragment)
|
Parameter |
Finding |
Points |
|
hormone status |
positive |
0 |
|
|
negative |
1 |
|
ECOG performance |
0, 1 or 2 |
0 |
|
|
3 or 4 |
1 |
|
previous chemotherapy |
<= 3 |
0 |
|
|
>= 4 |
1 |
|
Cyfra 21-1 in CSF |
<= 4 ng/mL |
0 |
|
|
> 4 ng/mL |
1 |
where:
• Hormone status negative was not defined. Presumably negative for estrogen and progesterone receptors. This group would include triple negative tumors.
complete score =
= SUM(all 4 parameters)
simplified score =
= SUM(points for first 3 parameters without Cyfra-21)
Interpretation:
• minimum score: 0
• maximum complete score: 4
• maximum simplified score: 3
• The higher the score the worse the prognosis.
• A simplified score of 0 was associated with a 33% overall survival at 24 months. A simplified score of 1 had a 100% mortality at 15 months. A simplified score of 2 or 3 had a 100% mortality at 4 months.
Specialty: Hematology Oncology, Surgery, general
