Halabi et al developed a nomogram for predicting prognosis in a man with hormone refractory metastastic prostate cancer. This can help identify a patient who may benefit from more aggressive or a novel therapy. The authors are from Duke University, the University of California San Francisco, Dana-Farber Cancer Institute, Memorial Sloan-Kettering Cancer Center, Roswell Park Cancer Institute, University of Maryland and the University of Chicago.
Patient selection: metastatic prostate cancer that is hormone resistant with ECOG score 0, 1 or 2
Parameters from pretreatment data:
(1) visceral disease
(2) Gleason score
(3) ECOG performance status
(4) baseline PSA in ng/mL
(5) serum LDH in IU/L
(6) serum alkaline phosphatase in IU/L
(7) hemoglobin in g/dL
|
Parameter |
Finding |
Points |
|
visceral disease |
no |
0 |
|
|
yes |
8 |
|
Gleason score |
2 to 7 |
0 |
|
|
8 to 10 |
16 |
|
ECOG performance status |
0 |
0 |
|
|
1 |
19 |
|
|
2 |
38 |
points for hemoglobin =
= 68.13 - (4 * (hemoglobin in g/dL))
|
serum PSA |
points for serum PSA |
|
<= 1 |
0 |
|
1 to 20 |
(-0.85 * (PSA)) + (8.549 * SQRT(PSA)) - 7.564 |
|
20 to 500 |
(-0.02039 * (PSA)) + (1.417 * SQRT(PSA)) + 8.14 |
|
500 to 5,000 |
(-0.004644 * (PSA)) + (0.5972 * SQRT(PSA)) + 18.94 |
|
5,000 |
38 |
|
serum LDH |
points for serum LDH |
|
< 6 |
0 |
|
6 to 200 |
(-0.3135 * (LDH)) + (9.636 * SQRT(LDH)) - 20.39 |
|
200 to 4,000 |
(-0.01348 * (LDH)) + (1.956 * SQRT(LDH)) + 29.79 |
|
4,000 |
100 |
|
serum alkaline phosphatase |
points for serum alkaline phosphatase |
|
< 10 |
0 |
|
10 to 150 |
(-0.2210 * (ALKP)) + (6.417 * SQRT(ALKP)) - 17.59 |
|
150 to 2,500 |
(-0.01305 * (ALKP)) + (1.574 * SQRT(ALKP)) + 10.85 |
|
2,500 |
57 |
total score =
= SUM(points for all 7 parameters)
|
Total Points |
Probability of 12 Month Survival |
|
< 66 |
> 90% |
|
66 to 250 |
see below |
|
> 250 |
< 1% |
X for 12 month survival =
= (-0.000015 * ((points)^2)) - (0.003391 * (points)) + 1.043
probability of 12 month survival =
= 1 / (1 + EXP((-1) * X))
|
Total Points |
Probability of 24 Month Survival |
|
< 75 |
> 70% |
|
75 - 121.7 |
see below |
|
121.7 - 200 |
see below |
|
> 200 |
< 1% |
Y for 24 month survival for 75 to 121.7 =
= (-0.000015 * ((points)^2)) - (0.003391 * (points)) + 1.043
Y for 24 month survival for 121.7 to 200 =
= (0.000050 * ((points)^2)) - (0.02116 * (points)) + 2.232
probability of 24 month survival =
= 1 / (1 + EXP((-1) * Y))
|
points |
months median survival |
|
< 55 |
> 72 months |
|
55 to 91 |
(0.03093 * ((points)^2)) - (5.653 * (points)) + 288.9 |
|
91 to 200 |
(0.001241 * ((points)^2)) - (0.5781 * (points)) + 71.97 |
|
> 200 |
< 6 months |
Specialty: Hematology Oncology, Surgery, general, Urology
