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Prognostic Index of Chau et al for Patients with Locally Advanced or Metastatic Esophago-Gastric Cancer

Purpose: To evaluate a patient with locally advanced or metastatic cancer of the esophagus or stomach using the prognostic index of Chau et al.

Description

Chau et al developed a simple prognostic index for evaluating patients with carcinomas of the esophagus or stomach that are locally advanced or metastatic. This can help identify patients who may benefit from more aggressive management. The authors are from Royal Marsden Hospital in London.


Patient selection:

(1) cancer of the esophagus, esophagogastric junction or stomach of any histologic type

(2) locally advanced or metastatic

 

Parameters:

(1) performance status

(2) liver metastases

(3) peritoneal metastases

(4) serum alkaline phosphatase

 

Parameter

Finding

Points

ECOG performance status

0 or 1

0

 

2, 3 or 4

1

liver metastases

none

0

 

present

1

peritoneal metastases

none

0

 

present

1

serum alkaline phosphatase

< 100 U/L

0

 

>= 100 U/L

1

 

where:

• The method and normal reference range for serum alkaline phosphatase was not listed.

 

index score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum index: 0

• maximum index: 4

• The higher the score, the worse the prognosis.

 

Index

Risk Group

Median Survival

1 Year Survival

0

good

12 months

49%

1 or 2

moderate

7 months

26%

3 or 4

poor

4 months

11%

from Figure 2, page 2400, survival numbers rounded


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Specialty

Objective

ICD-10