Atzpodien et al developed a prognostic model for patients with metastatic renal cell carcinoma. This can help compare the outcomes for different treatment regimens. The authors are from the German Cooperative Renal Carcinoma Chemo-Immunotherapy Trials Group (DGCIN).
Patient selection: adults with metastatic renal cell carcinoma, treated with combinations of interferon, interleukin-2, 5-fluorouracil (5-FU), and 13-cis-retinoic acid.
Parameters:
(1) neutrophil count
(2) serum C-reactive protein (CRP)
(3) serum LDH
(4) time between diagnosis of the tumor and diagnosis of metastastic disease
(5) number of metastatic sites
(6) bone metastases
The neutrophil count was considered a major criterion while the others were considered minor criteria.
|
Parameters |
Findings |
Points |
|
neutrophil count |
< 6,500 per µL |
0 |
|
|
>= 6,500 per µL |
2 |
|
serum CRP |
< 11 mg/L |
0 |
|
|
>= 11 mg/L |
1 |
|
serum LDH |
< 220 IU/L |
0 |
|
|
>= 220 IU/L |
1 |
|
time interval to metastasis |
< 3 years |
0 |
|
|
>= 3 years |
1 |
|
number of metastatic sites |
0 to 2 |
0 |
|
|
>= 3 |
1 |
|
bone metastases |
absent |
0 |
|
|
present |
1 |
where:
• The normal reference range for serum LDH was 80 - 240 IU/L, with mean of 160 IU/L. The cutoff is 1.375 times the mean of the normal reference range.
• The normal reference range for neutrophil count is 1,500 - 7,500 per µL.
• The normal reference range for CRP was < 5 mg/L. The cutoff is 2.2 times the upper limit of the normal reference range.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the worse the prognosis.
|
Total Score |
Risk Group |
Probability of 5 Year Survival |
|
0 or 1 |
low risk |
27% |
|
2 or 3 |
intermediate risk |
11% |
|
4 to 7 |
high risk |
5% |
from Figure 3B on page 351
Specialty: Hematology Oncology, Surgery, general, Nephrology
ICD-10: ,
