van den Broek et al developed models for predicting outcome for patients with advanced head and neck cancer treated with targeted chemoradiation. The model for 2 year survival uses variables available prior to treatment and can help identify patients who may require more aggressive management. The authors are from the Netherlands Cancer Institute at Antoni Van Leeuwenhoek Hospital in Amsterdam, The Netherlands.
Patient selection: T3 or T4 head and neck carcinoma with ASA class I, II or III.
Parameters:
(1) age of the patient in years
(2) tumor volume in cubic cm (mL)
(3) gender of the patient
(4) N classification
(5) T classification
(6) lowest neck node level
(7) weight loss > 10%
(8) ASA score
|
Parameter |
Finding |
Points |
|
gender of the patient |
female |
0 |
|
|
male |
15 |
|
T classification |
T3 |
8.3 |
|
|
T4 |
0 |
|
N classification |
N0 or N1 |
0 |
|
|
N2 or N3 |
4.2 |
|
lowest neck node level |
none |
0 |
|
|
II or III |
0 |
|
|
IV |
27.5 |
|
weight loss > 10% |
no |
0 |
|
|
yes |
17.5 |
|
ASA score |
I |
0 |
|
|
II or III |
23.33 |
|
Tumor Volume |
Points |
|
0 mL |
0 |
|
50 mL |
13.3 |
|
100 mL |
23.3 |
|
150 mL |
36.7 |
|
200 mL |
48.3 |
|
250 mL |
61.7 |
|
300 mL |
74.2 |
|
350 mL |
86.7 |
|
>= 400 mL |
100 |
points for volume up to 400 mL =
= (0.249 * (volume in mL)) - 0.4444
|
Age of the Patient |
Points |
|
<=40 years of age |
23.9 |
|
45 years of age |
5.4 |
|
50 years of age |
0 |
|
55 years of age |
0 |
|
60 years of age |
1.7 |
|
>= 65 |
2.5 |
points for age 40 to 50 =
= (0.042 * ((age in years)^2) - (5.07 * (age in years)) + 148.5
points for age 55 to 65 =
= (-0.018 * ((age in years)^2) + (2.41 * (age in years)) - 78.1
total score =
= SUM(points for all 8 parameters)
The probability of 2 year survival is read off the graph in Figure 3. This can be approximated by the formula:
probability of 2 year survival =
= > 91% if points < 10
= < 16% if points > 75
= ((-0.01158 * ((points)^2)) - (0.17933 * (points)) + 93.87022) / 100 * 100%
Specialty: Hematology Oncology, Surgery, general, Otolaryngology
