NOTE: The authors have labeled the Tables and Figures as "Extrapulmonary Squamous Cell Carcinoma" while the text clearly discusses small cell carcinoma that shows neuroendocrine markers.
Primary sites of origin:
(1) breast
(2) gastrointestinal tract
(3) genitourinary tract (including prostate gland in males)
(4) gynecologic tract (including the cervix and vagina)
(5) head and neck
(6) thymus
(7) unknown
Poor prognostic factors:
(1) white blood cell count
(2) ECOG performance status
(3) tumor stage (using a 2 stage system from the VA Lung Study Group)
|
Parameter
|
Finding
|
Points
|
|
white blood cell count
|
< 4,800 per µL (low abnormal)
|
1
|
|
|
4,800 to 10,800 per µL
|
0
|
|
|
> 10,800 per µL (high abnormal)
|
1
|
|
ECOG performance scale
|
0 to 2
|
0
|
|
|
3 or 4
|
1
|
|
tumor stage
|
limited stage (localized)
|
0
|
|
|
extensive
|
1
|
where:
• Limited stage disease is confined to the primary site with or without regional lymph node metastases. Practically this was an area that could be covered within 1 radiation therapy treatment port.
• Extensive disease was any tumor beyond locoregional boundaries. The poor prognosis for tumor of unknown primary site suggests that it should be included here.
total number of poor prognostic factors =
= SUM(points for all 3 parameters)
Favorable prognostic factors:
(1) primary site in the gynecologic tract or breast
(2) limited stage disease with complete response to therapy
