Beyer et al developed a prognostic score for patients with metastatic germ cell tumors who are treated with high dose chemotherapy. This can help identify patients with a poor prognosis prior to starting the chemotherapy. The authors are from Indiana University (USA), Institut Gustave Roussy (France), Allgemeines Krankenhaus der Stadt Wien (Austria) and Virchow Klinikum (Germany).
Parameters - all measured before starting high dose chemotherapy:
(1) progressive disease
(2) site of primary tumor
(3) response to cisplatin (either susceptible, refractory, or absolute refractory)
(4) serum HCG
|
Parameter |
Finding |
Points |
|
progressive disease |
present |
1 |
|
|
absent |
0 |
|
site of primary tumor |
mediastinum |
1 |
|
|
gonadal or retroperitoneum |
0 |
|
response to cisplatin |
susceptible |
0 |
|
|
refractory |
1 |
|
|
absolute refractory |
2 |
|
serum HCG |
> 1,000 U/L |
2 |
|
|
<= 1,000 U/L |
0 |
where:
• Stable disease was a response that did not qualify as marker negative partial remission, marker positive partial remission, or progressive disease.
• Refractory response achieved stable disease or better, but tumor progressed within 4 weeks of last cisplatin dose
• Absolute refractory disease to cisplatin did not achieve stable disease.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
|
Total Score |
Risk Group |
FFS at 2 Years |
Overall Survival at 2 Years |
|
0 |
low |
51% |
61% |
|
1 or 2 |
intermediate |
27% |
34% |
|
3 to 6 |
high |
5% |
8% |
where:
• FFS involves treatment failure as determined by disease progression, relapse or death.
Specialty: Hematology Oncology, Surgery, general, Urology
ICD-10: ,
