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Predictors of Hudes et al for Poor Survival in a Patient with Metastatic Renal Cell Carcinoma

Description

Hudes et al listed a number of findings that can be used to identify a patient with metastatic renal cell carcinoma who has a poor prognosis. These patients may benefit from more aggressive or novel therapies. The authors are from multiple universities from North America and Europe enrolled in the Global ARCC Trial.


 

Patient selection: metastatic renal cell carcinoma with Karnofsky performance status >= 60

 

Parameters:

(1) serum LDH concentration

(2) hemoglobin

(3) corrected serum calcium

(4) interval between initial diagnosis and selection for therapy of metastatic disease

(5) Karnofsky performance status )KPS)

(6) number of organs with metastases (not total number of metastases)

Parameter

Finding

Points

serum LDH

<= 1.5 times upper limit of normal

0

 

> 1.5 times upper limit of normal

1

hemoglobin

>= lower limit of normal

0

 

< lower limit of normal

1

corrected serum calcium

<= 10 mg/dL (2.5 mmol/L)

0

 

> 10 mg/dL

1

interval from initial diagnosis

>= 1 year

0

 

< 1 year

1

Karnofsky Performance Status

80 to 100

0

 

60 pr 70

1

number of organs with metastases

1

0

 

2 or more

1

 

total score =

= SUM(points for all 6 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 6

• A person with 3 or more risk factors was more likely to show a short survival.

 


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Specialty

ICD-10