Armstrong et al reported a prognostic model for predicting overall survival of a male with prostate cancer. This can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in the United States and Europe.
Patient selection: metastatic castration-resistant prostate cancer, chemotherapy naive
Parameters:
(1) number of bone metastases
(2) pattern of spread (liver metastases)
(3) pain on a 10 cm Likert scale
(4) serum alkaline phosphatase in IU/L
(5) neutrophil to lymphocyte ratio (NLR)
(6) serum LDH in IU/L
(7) treatment
(8) serum albumin in g/dL, from 2.5 to 4.9
(9) number of years since diagnosis, from 0 to 23 years
(10) hemoglobin in g/dL, from 7.4 to 16.8
(11) serum PSA in ng/mL
points for serum albumin =
= 78.604 - (16.042 * (albumin))
points for hemoglobin =
= 131 - (7.8 * (hemoglobin))
points for time since diagnosis =
= 46.22 - (2.01 * (years))
points for serum PSA =
= (21.821 * LOG10(serum PSA)) + 21.686
Parameter |
Finding |
Points |
number of bone metastases |
0 to 9 |
0 |
|
>= 10 |
18 |
liver metastases |
none |
0 |
|
>= 1 |
32.5 |
pain |
0 or 1 |
0 |
|
>= 2 |
12.2 |
serum alkaline phosphatase |
< ULN |
0 |
|
>= ULN |
11.2 |
NLR |
< 2.5 |
0 |
|
>= 2.5 |
18 |
serum LDH |
< ULN |
0 |
|
>= ULN |
18.9 |
treatment |
enzalutamide |
0 |
|
placebo |
18 |
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 382.2
• The higher the score the worse the overall survival.
Score |
Probability of 3-Year Overall Survival |
< 100 |
> 89% |
100 to 190 |
(-0.005375 * (score)) + 1.4338 |
190 to 270 |
|
> 270 |
< 18% |
Specialty: Hematology Oncology