Curran et al developed a score for patients with pleural mesothelioma based on survival of patients in the European Organization for Research and Treatment of Cancer (EORTC) Clinical Trials. This can be used to separate patients into good and poor prognostic groups. The authors are from the EORTC Data Center in Brussels and universities in Belgium and the Netherlands.
Parameters:
(1) white blood cell (WBC) count
(2) ECOG performance status
(3) certainty of histologic diagnosis
(4) histologic subtype
(5) patient gender
Parameter |
Finding |
Points |
---|---|---|
WBC count |
<= 8,300 per µL |
0 |
|
> 8,300 per µL |
1 |
performance status |
0 (asymptomatic) |
0 |
|
1 or 2 |
1 |
certainty of histologic diagnosis |
definite |
0 |
|
possible or probable |
1 |
histologic subtype |
epithelial |
0 |
|
mixed |
0 |
|
sarcomatoid |
1 |
gender |
female |
0 |
|
male |
1 |
where:
• Patients with a definite histologic diagnosis of mesothelioma had a better survival than those with less certainty.
• Patients with poor performance status (ECOG 3 or 4) were not included but would be expected to have a poor outcome.
number of factors present =
= SUM(points for all 5 parameters)
prognostic score =
= (0.55 * (points for WBC count)) + (0.60 * (points for performance status)) + (0.52 * (points for histologic certainty)) + (0.67 * (points for histologic subtype)) + (0.60 * (points for gender))
Interpretation:
• minimum score: 0
• maximum score: 2.94
• minimum number of risk factors: 0
• maximum number of risk factors: 5
Prognostic Score |
Number of Risk Factors |
Prognostic Group |
1 Year Survival |
2 Year Survival |
---|---|---|---|---|
<= 1.27 |
0 - 2 |
good |
40% |
14% |
> 1.27 |
3 - 5 |
poor |
12% |
0% |
Purpose: To determine the prognosis for a patient with pleural mesothelioma using the score of Curran et al based on the EORTC clinical trial data.
Specialty: Hematology Oncology, Surgery, general, Pulmonology
Objective: severity, prognosis, stage
ICD-10: C45,