Galsky et al developed a nomogram for predicting survival for a patient with advanced urothelial carcinoma prior to starting chemotherapy with cisplatin. This can help to identify a patient who may benefit from more aggressive or from an alternative therapy. The authors are from Mount Sinai School of Medicine and multiple institutions in the United States, Taiwan and Europe.
Patient selection: urothelial carcinoma that is metastatic or unresectable (Stage cT4b) AND ECOG performance status 0 to 2 AND treated with cisplatin
Parameters:
(1) white blood cell count
(2) number of sites of visceral metastases
(3) location of primary tumor
(4) ECOG performance status
(5) lymph node metastases
|
Parameter |
Finding |
Points |
|
white blood cell count |
elevated |
63.3 |
|
|
not elevated |
0 |
|
number of sites with visceral metastases |
0 |
0 |
|
|
1 |
34.7 |
|
|
2 |
90 |
|
|
3 |
100 |
|
location of primary tumor |
urinary bladder |
0 |
|
|
other |
16 |
|
ECOG performance |
0 |
0 |
|
|
1 |
32.7 |
|
|
2 |
94 |
|
lymph node metastases |
no |
0 |
|
|
yes |
18.4 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: around 292
• The higher the score the worse the median survival time in months.
|
Total Score |
Median Survival in Months |
|
0 to 90 |
(0.001247 * ((points)^2)) - (0.323 * (points)) + 33.14 |
|
90 to 155 |
20.68 - (0.07596 * (points)) |
|
155 to 260 |
14.76 - (0.03771 * (points)) |
|
> 260 |
< 5 |
Specialty: Hematology Oncology, Surgery, general, Urology
ICD-10: ,
