Chen et al reported a model for predicting mortality for an adult with squamous cell carcinoma of the esophagus. This can help to identify a patient who may benefit from more aggressive or novel therapy. The authors are from Zhejiang Cancer Hospital and the Key Laboratory for Diagnosis and Treatment Technology on Thoracic Oncology in Hangzhou, China.
Patient selection: esophageal squamous cell carcinoma, non-metastatic
Outcome: 5-year cancer-specific mortality
Parameters:
(1) age in years, from 35 to 80 years
(2) sex
(3) stage based on TNM
(4) platelet count per microliter
(5) absolute lymphocyte count per microliter
(5) serum CRP in mg/L
(6) prognostic nutritional index (PNI) of Odonera
platelet to lymphocyte ratio = PLR =
= (platelet count) / (absolute lymphocyte count)
CRP to PNI ratio =
= (CRP) / (PNI)
points for age=
= (1.178 * (age)) - 41.222
Parameter
|
Finding
|
Points
|
sex
|
male
|
0
|
|
female
|
10.8
|
TNM stage
|
Stage I
|
0
|
|
Stage II
|
50
|
|
Stage III
|
100
|
PLR
|
<= 150
|
0
|
|
> 150
|
79
|
CRP to PNI ratio
|
<= 0.1
|
0
|
|
> 0.1
|
90
|
where:
• The nomogram shows results for 0 and 1, without specific definitions. The entries above are based on assumptions from Table 2.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 332.8
• The higher the score the greater the risk of mortality.
value of X =
= (0.0077078 * (score)) - 1.3114
probability of 5-year cancer specific mortality =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve for CSS was 0.69.