A simple prognostic index can be used in patients with non-small lung carcinoma. This can help to determine the aggressiveness of therapy in the individual patient and to compare outcomes for different treatment regimens in patient populations.
Parameters:
(1) clinical symptom group of Feinstein
(2) Karnofsky performance index
(3) tumor stage
(4) tumor size in centimeters
(5) hemoglobin
Clinical symptom groups of Feinstein:
(1) none or asymptomatic
(2) local or primary
(3) generalized or systemic: anorexia, fatigue, etc.
(4) metastatic: bone pain, certain neurologic manifestations, etc.
|
Parameter |
Finding |
Points |
|
clinical symptom group of Feinstein |
none or localized |
0 |
|
|
generalized or metastatic |
1 |
|
Karnofsky performance scale |
> 70 |
0 |
|
|
<= 70 |
1 |
|
stage |
I or II |
0 |
|
|
III |
1 |
|
tumor size in cm |
< 7 |
0 |
|
|
>= 7 |
1 |
|
hemoglobin in g/dL |
>= 12.5 |
0 |
|
|
< 12.5 |
1 |
prognostic index =
= SUM(points for 5 parameters)
Interpretation:
• minimum score 0
• maximum score 5
• If 3 or more predictors of poor outcome are present, then survival at 24 months is almost nil. If none are present, then over half are alive at 24 months.
|
Index |
6 month survival |
12 month survival |
24 month survival |
mean survival time |
|
0 |
100% |
82% |
53% |
27 months |
|
1 |
91% |
73% |
36% |
18 months |
|
2 |
84% |
53% |
10% |
12 months |
|
3 |
64% |
27% |
2% |
8 months |
|
4 |
37% |
7% |
0% |
4 months |
|
5 |
39% |
15% |
0% |
4 months |
(after Table 4, Wigren 1997, pages 13)
Specialty: Hematology Oncology, Surgery, general, Pulmonology
ICD-10: ,
