Deans et al developed a clinical score for helping to determine the prognosis for a patient with cancer of the esophagus, stomach and gastroesophageal junction. The authors are from the Royal Infirmary in Edinburgh.
Patient selection: cancer of esophagus, stomach or gastroesophageal (GE) junction
Outcome: mortality
Parameters:
(1) C-reactive protein (CRP) in mg/L
(2) percent weight loss per month
(3) Karnofsky score from 10 to 100
(4) clinical TNM stage
|
Parameter |
Finding |
Points |
|
CRP |
<= 5 mg/L |
0 |
|
|
> 5 mg/L |
20 |
|
percent weight loss |
<= 2.75% per month |
0 |
|
|
> 2.75% per month |
20 |
|
Karnofsky score |
80 to 100 |
0 |
|
|
60 to 70 |
32 |
|
|
< 60 |
68 |
|
clinical TNM stage |
I |
0 |
|
|
II |
30 |
|
|
III |
46 |
|
|
IV |
94 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 202
• The higher the score the worse the survival.
• 12 and 24 months mortality curves are given in Figure 1. To be noted is that the intervals along the X-axis are not constant but vary from 4 to 20.
|
Score |
24-month Mortality Rate |
|
0 to 20 |
0 |
|
20 to 66 |
(-0.002875 * ((score)^2)) + (0.5382 * (score)) - 9.684 |
|
66 to 114 |
(-0.005322 * ((score)^2)) + (1.76 * (score)) - 79.65 |
|
114 to 202 |
(-0.001337 * ((score)^2)) + (0.9997 * (score)) - 44.85 |
Performance:
• The area under the ROC curve is around 0.85.
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
