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Prognostic Factor Risk Index of Shinkai et al for Advanced Non-Small-Cell Lung Cancer

Purpose: To estimate the prognosis for patients with advanced non-small-cell carcinomas of the lung based on clinical and laboratory findings.

Description

The prognosis in patients with advanced non-small cell (non-oat cell) carcinoma of the lung who were treated with cisplatin-containing chemotherapy can be assessed by a prognostic index using clinical and laboratory data.


Patients selected

(1) non small cell carcinomas: adenocarcinoma, squamous cell, large cell undifferentiated

(2) stage: stages III and IV

 

Parameters:

(1) number of metastatic sites

(2) gender

(3) serum albumin in g/dL

(4) Eastern Cooperative Oncology Group (ECOG) performance status

(5) serum LDH in IU/L

 

Parameter

Finding

Value

number of metastatic sites

0

0

 

1

0.4253

 

>= 2

2 * (0.4253) = 0.8506

sex

female

0

 

male

0.6116

serum albumin

>= 3.7 g/dL

0

 

< 3.7 g/dL

0.4936

ECOG performance status

0

0

 

1

0.4664

 

2

2 * (0.4664) = 0.9328

 

3 or 4

excludes patient (see below)

LDH

<= 350 IU/L

0

 

> 350 IU/L

0.5242

 

where:

• ECOG 0 (asymptomatic), 1 (symptomatic but ambulatory), 2 (bedridden < half the day), 3 (bedridden >= half the day), and 4 (chronically bedridden, needing assistance in activities of daily living).

• Patients with ECOG performance status of 3 or 4 were excluded since their prognosis was uniformly poor.

 

prognostic index =

= (value for metastatic sites) + (value for sex) + (value for serum albumin) + (value for performance status) + (value for LDH)

 

Interpretation

• minimum prognostic index: 0

• maximum prognostic index: 3.4128

 

Prognostic Index (Group)

Percent with 1 Year Survival

Percent with 2 Year Survival

Median Survival in Months

Response Rate in Percent

< 1.3 (good)

73.1

26.1

16.5

42.3%

1.3 - 2.1999 (intermediate)

36

11

9.4

30.2%

> = 2.2 (poor)

11.6

0

4.6

29.2%

 


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Specialty

Objective

ICD-10