Argiris et al identified prognostic factors associated with survival in patients with recurrent or metastatic carcinoma of the head and neck. This can help identify patients who may benefit from more aggressive or investigational therapies. The authors are from Northwestern University, Dana-Farber Cancer Institute and the Johns Hopkins University.
Patient selection: recurrent or metastatic head and neck carcinoma
Prognostic factors:
(1) weight loss
(2) ECOG performance scale
(3) tumor differentiation
(4) tumor location
(5) history of previous radiation therapy
|
Prognostic Factor |
Finding |
Points |
|
weight loss |
<= 5% |
0 |
|
|
> 5% |
1 |
|
ECOG performance scale |
PS 0 |
0 |
|
|
PS 1 |
1 |
|
tumor differentiation |
well-differentiated |
1 |
|
|
moderately differentiated |
1 |
|
|
poorly differentiated |
0 |
|
tumor location |
oral cavity |
1 |
|
|
hypopharynx |
1 |
|
|
other location |
0 |
|
history of previous radiation therapy |
no |
0 |
|
|
yes |
1 |
number of adverse factors =
= SUM(points for all 5 factors)
Factors associated with 2 year survival
(1) ECOG performance scale
(2) tumor differentiation
(3) history of previous radiation therapy
(4) response to chemotherapy
(5) race
|
Survival Factor |
Finding |
Points |
|
ECOG performance scale |
PS 0 |
1 |
|
|
PS 1 |
0 |
|
tumor differentiation |
well-differentiated (Grade I) |
0 |
|
|
moderately differentiated (Grade II) |
0 |
|
|
poorly differentiated (Grade III) |
1 |
|
history of previous radiation therapy |
no |
1 |
|
|
yes |
0 |
|
response to chemotherapy |
complete response |
1 |
|
|
partial response |
1 |
|
|
no response |
0 |
|
race |
Caucasian/White |
1 |
|
|
other |
0 |
number of 2 year survival factors =
= SUM(points for all 5 factors)
Interpretation:
• minimum number of adverse risk factors: 0
• maximum number of adverse risk factors: 5
• minimum number of survival factors: 0
• maximum number of survival factors: 5
|
Adverse Factors |
Median Survival |
2 Year Survival |
5 Year Survival |
|
0 to 2 |
1 year |
28% |
7% |
|
3 to 5 |
0.5 years |
6% |
1% |
Specialty: Hematology Oncology, Surgery, general, Otolaryngology
