Wang et al developed 2 nomograms to help to decide if a patient with gallbladder cancer will benefit from adjuvant radiotherapy (RT). One nomogram predicts survival with adjuvant RT while the other without RT. The authors are from Oregon Health and Science University, Portland State University, Northwest Permanente PC, University of Texas Health Science Center at San Antonio and M.D. Anderson Cancer Center in Houston.
Patient selection: gallbladder cancer
The benefit of adjuvant RT is the difference between survival with and without the RT.
Parameters:
(1) age in years
(2) gender
(3) race
(4) histologic pattern
(5) T stage
(6) N status
|
Parameter |
Finding |
Points |
|
gender |
female |
0 |
|
|
male |
4.2 |
|
race |
Asian |
0 |
|
|
Pacific Islander |
0 |
|
|
White |
6.2 |
|
|
Black |
9.7 |
|
histologic pattern |
papillary |
0 |
|
|
non-papilary |
19.4 |
|
Age |
Points |
|
20 to 70 years |
(0.558 * (age)) - 4.96 |
|
70 to 100 years |
(0.0285 * ((age)^2)) - (3.249 * (age)) + 120.6 |
|
T and M Stage |
N0 |
N1 |
|
T1 M0 |
12.5 |
8.9 |
|
T2 M0 |
0 |
3.1 |
|
T3 M0 |
14.9 |
18 |
|
T4 M0 |
23.5 |
26.6 |
|
Tx M1 |
37.4 |
40.8 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: > 180
• The higher the score the worse the overall survival.
|
Score |
Probability of 24 Month Survival after Adjuvant RT |
|
< 22.4 |
> 80% |
|
22.4 to 60.3 |
(-0.006442 * ((points)^2)) - (0.2609 * (points)) + 89.11 |
|
60.3 to 100.9 |
(0.00433 * ((points)^2)) - (1.697 * (points)) + 136.9 |
|
> 100.9 |
< 10% |
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
