Sawaki et al developed a prognostic index for evaluating a patient with metastatic pancreatic carcinoma treated with gemcitabine. The authors are from Aichi Cancer Center Hospital in Nagoya, Japan.
Dosing regimen for gemcitabine: 1 gram per square meter BSA weekly for 3 weeks, followed by 1 week rest
Parameters:
(1) ECOG performance scale
(2) location of the primary tumor in the pancreas
(3) serum C-reactive protein (CRP) concentration
|
Parameter |
Finding |
Points |
|
ECOG performance scale |
0 or 1 |
1 |
|
|
2 |
2 |
|
|
3 |
5 |
|
location of the primary tumor |
body or tail |
1 |
|
|
head |
3 |
|
serum CRP |
< 1 mg/dL |
1 |
|
|
1 - 3 mg/dL |
3 |
|
|
> 3 mg/dL |
6 |
where:
• ECOG 4 was not mentioned but would be associated with a poor prognosis.
prognostic index =
= SUM(points for all 3 parameters)
Interpretation:
• minimum index: 3
• maximum index: 14
• The higher the index the worse the prognosis.
|
Index |
Median Survival |
Benefit of Gemcitabine |
|
3 or 4 |
265 days |
good prognosis without gemcitabine |
|
5 to 8 |
155 days |
likely to benefit from gemcitabine |
|
9 to 12 |
65 days |
unlikely to benefit from gemcitabine |
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
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