Sudo et al developed a nomogram for predicting distant metastases after a patient has received multimodality therapy for localized esophageal cancer. This can help to identify a patient who may benefit from more aggressive management. The authors are from University of Texas MD Anderson Cancer Center in Houston.
Patient selection: localized esophageal cance after multimodality therapy
Outcome: distant metastases
Parameters:
(1) age in years
(2) baseline T
(3) baseline N
(4) tumor grade
(5) histologic tumor type
(6) treatment modality (trimodality if surgery performed <=6 months after chemoradiation; bimodality if no surgery or if surgery performed > 6 months after chemoradiation)
|
Parameter |
Finding |
Points |
|
age in years |
< 60 years |
26.6 |
|
|
>= 60 years |
0 |
|
baseline T |
T1 or T2 |
0 |
|
|
T3 or T4 |
100 |
|
baseline N |
N0 |
0 |
|
|
N1 |
62.3 |
|
tumor grade |
well-differentiated |
0 |
|
|
moderately differentiated |
0 |
|
|
poorly differentiated |
50 |
|
histologic tumor type |
squamous cell |
0 |
|
|
adenocarcinoma |
54.7 |
|
treatment modality |
trimodality |
0 |
|
|
bimodality |
49.2 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 342.8
• The higher the score the less likely that patient is to be free of distant metastases.
|
Total Score |
2-Year Metastases-Free |
|
< 47 |
> 95% |
|
47 to 328 |
(-0.00077 * ((points)^2)) + (0.06225 * (points)) + 93.42 |
|
> 328 |
< 30% |
|
Total Score |
5-Year Metastases-Free |
|
< 31 |
> 95% |
|
31 to 313 |
(-0.000773 * ((points)^2)) + (0.03698 * (points)) + 94.23 |
|
> 313 |
< 30% |
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
