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Predictors of Wright et al for Survival in a Patient with Incurable Stage IV Cancer and Malignant Bowel Obstruction

Description

Wright et al identified factors associated with survival in patients with incurable Stage IV carcinoma and malignant bowel obstruction. These can help to identify patients who may not benefit from more aggressive management. The authors are from Sunnybrook Health Science Centre (Toronto) and Queen Elizabeth II Health Science Centre (Halifax) in Canada.


Patient selection: incurable Stage IV cancer with malignant bowel obstruction

 

Outcome: overall survival

 

Parameters:

(1) ECOG performance status

(2) serum/blood urea nitrogen in mg/dL

(3) serum albumin in g/L

 

Parameter

Finding

Hazard Ratio

ECOG performance

0 or 1

1

 

2

12.5

 

3 or 4

35.8

BUN

normal

1

 

elevated

2.9

serum albumin

normal

1

 

decreased

NA

 

where:

• The methods and reference levels for BUN and serum albumin are not stated.

• The hazard ratio of various levels of hypoalbuminemia are not given.

 

Interpretation:

• Survival is primarily determined by the ECOG score. An ECOG of 3 or 4 is associated with poor survival and an ECOG score of 2 is associated with a guarded prognosis.

• For an ECOG of 0 or 1 the BUN and serum albumin would stratify the patient.


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