medical decision support medical decision support
Sign In

Prognostic Score of Schindl et al for a Patient with Colorectal Cancer and Liver Metastases

Purpose: To evaluate a patient with colorectal cancer and liver metastases using the prognostic score of Schindl et al.

Description

Schindl et al developed a prognostic score for patients with colorectal cancer and liver metastases referred for possible resection of the liver metastases. This can help identify those patients who may have a poor outcome after surgery and who may benefit from more novel therapies. The authors are from the University of Vienna and Royal Infirmary of Edinburgh in Scotland.


Parameters:

(1) Duke stage

(2) number of hepatic metastases

(3) serum alkaline phosphatase in IU/L

(4) serum CEA level in µg/L

(5) serum albumin in g/dL

 

Parameter

Finding

Points

Duke stage

A or B

0

 

C

1

number of hepatic metastases

1 to 3

0

 

>= 4

1

 

where:

• The reference range for serum alkaline phosphatase was 40 - 125 IU/L.

• The reference range for serum CEA was < 5 µ/L.

• The reference range for serum albumin was 3.6 - 4.7 g/dL.

 

X =

= (4 * (points for Duke stage)) + (6 * (points for number of hepatic metastases)) + (6 * LN(serum alkaline phosphatase)) + (2 * LN(serum CEA)) - (serum albumin) + 22

 

NOTE: The addition of 22 to the score means that it is very hard to get a patient in the good prognostic group. The only way this can be achieved is by having very low values for CEA and high levels of serum albumin. I would definitely try to validate the score before using it clinically.

 

prognostic score =

= ROUND(X, 0)

 

Interpretation:

• minimum score: 0

• maximum score: > 25

• The higher the score the worse the prognosis.

 

Total Score

Prognosis

Median Survival

0 to 10

good

35.7 months

11 to 25

moderate

23.5 months

>= 26

poor

10.6 months

 


To read more or access our algorithms and calculators, please log in or register.

Specialty

Objective

ICD-10