Cheung et al developed a model for identifying a patient with colon cancer who is at risk for early mortality. These patients may benefit from more aggressive management. The authors are from multiple hospitals in North America and Europe.
Patient selection: adult 20 to 100 years of age with colon cancer
Outcome: 6-month mortality rate
Parameters:
(1) age in years
(2) ECOG performance status
(3) histologic grade
(4) T stage
(5) lymph node ratio (LNR, lymph nodes with metastases divided by total number of nodes)
A sixth parameter for decade of the study would not be relevant for cases presenting today.
Parameter
Finding
Points
ECOG performance status
0
0
1
7
2 to 4
19.5
histologic grade
Grade 1
0
Grade 2
7.5
Grade 3 or undifferentiated
28.1
T status
T1
0
T2
16.8
T3
20.1
T4
28.8
points for lymph node ratio =
= 32.7 * (ratio)
Age in Years
Points
20 to 50 years
(0.333 * (age)) – 3.53
50 to 100
(0.0135 * ((age)^2)) – (0.2236 * (age)) – 11.26
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 209 (if sixth item not included)
• The higher the score the greater the chance of early mortality.
Points
Percent with Early Mortality
< 67.4
< 1%
67.4 to 112
0.09 * (score)) - 5.082
112 to 132
(0.24994 * (score)) - 22.987
132 to 154
(0.46097 * (score)) - 50.838
> 154
> 20%
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