Patient selection: woman with primary breast cancer
Outcome: 5-year survival (2-year survival also predicted in nomogram)
Parameters:
(1) diameter of the tumor in mm
(2) nodal status
(3) estrogen receptor (ER) in fmol per mg protein (Abbott Laboratories)
(4) thymidine kinase (TK) in mU per mg protein (TK-REA, Sangtec Medical)
(5) plasminogen activator inhibitor type 1 (PAI-1) in ng per mg protein (American Diagnostics)
(6) cathepsin D in pmol per mg protein (ELSA-Cath D, CIS Bio-Industries)
points for diameter =
= MIN(100, 0.833 * (diameter in mm))
points for ER =
= MAX(0,80 – (0.123 * (ER)))
points for thymidine kinase =
= MIN(74, 0.074 * (TK))
points for PAI-1 =
= MIN(75, 1.154 * (PAI-1))
|
Parameter
|
Finding
|
Points
|
|
lymph node metastases
|
no
|
0
|
|
|
yes
|
32
|
|
cathepsin-D expression
|
low
|
0
|
|
|
high
|
50
|
where:
• The definition for low vs high cathepsin was not given. The median value was 39.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 280
• The higher the score the worse the 5-year survival.
|
Total Score
|
5-Year Survival Rate
|
|
< 170
|
> 90%
|
|
170 to 245
|
(-0.007122 * ((points)^2)) + (1.834 * (points)) - 14.47
|
|
> 245
|
< 10%
|
Limitations:
• The results depends on having assays that give comparable results to those used in the study.
