Patient selection: skeletal metastasis
Parameters:
(1) cancer growth at primary site
(2) visceral metastasis
(3) laboratory data (serum CRP, serum LDH, serum albumin, platelet count, serum calcium, serum total bilirubin)
(4) ECOG performance status
(5) previous chemotherapy
(6) multiple skeletal metastases
|
Parameter
|
Finding
|
Points
|
|
cancer growth
|
slow
|
0
|
|
|
moderate
|
2
|
|
|
rapid
|
3
|
|
visceral metastases
|
no
|
0
|
|
|
yes, limited
|
1
|
|
|
disseminated
|
2
|
|
laboratory data
|
normal
|
0
|
|
|
abnormal
|
1
|
|
|
critical
|
2
|
|
ECOG PS
|
0 to 2
|
0
|
|
|
3 or 4
|
1
|
|
previous chemotherapy
|
no
|
0
|
|
|
yes
|
1
|
|
multiple skeletal mets
|
no (1)
|
0
|
|
|
yes
|
1
|
where:
• Abnormal lab tests: CRP >= 0.4 mg/dL; serum LDH >= 250 U/L; serum albumin < 3.7 g/dL.
• Critical lab tests: platelet count < 100,000 per µL; serum calcium >= 10.3 mg/dL; serum totla bilirubin >= 1.4 mg/dL.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the worse the prognosis.
• A score of 0 to 3 is low risk; of 4 to 6 moderate risk; of 7 to 10 high risk.
|
Total Score
|
12 month Survival
|
24 month Survival
|
|
0
|
100%
|
100%
|
|
1
|
95%
|
85%
|
|
2
|
97%
|
83%
|
|
3
|
87%
|
71%
|
|
4
|
75%
|
53%
|
|
5
|
53%
|
31%
|
|
6
|
33%
|
12%
|
|
7
|
10%
|
4%
|
|
8
|
4%
|
1%
|
|
9
|
0%
|
0%
|
|
10
|
0%
|
0%
|
