Huang et al developed a simple model for predicting survival for a patient with carcinoma of unknown primary site. The authors are from Chang Gung Memorial Hospital and University in Taiwan.
Patient selection: cancer of unknown primary, ECOG 1 to 4 (no ECOG 0)
Outcome: overall survival
Parameters:
(1) ECOG performance status
(2) neutrophil to lymphocyte ratio
(3) visceral organ involvement (lung, liver, peritoneum, bone marrow, central nervous system)
neutrophil to lymphocyte ratio =
= (absolute neutrophil count) / (absolute lymphocyte count)
|
Parameter
|
Finding
|
Points
|
|
ECOG performance
|
ECOG 1
|
0
|
|
|
ECOG 2 to 4
|
2
|
|
neutrophil to lymphocyte ratio
|
<= 3
|
0
|
|
|
> 3
|
1
|
|
visceral organ involvement
|
no
|
0
|
|
|
yes
|
1
|
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the worse the prognosis.
|
Total Score
|
Prognosis
|
Median Survival
|
|
0
|
good
|
1086 days
|
|
1 or 2
|
intermediate
|
305 days
|
|
3 or 4
|
poor
|
64 days
|
Performance:
• The area under the ROC curve is 0.80 for 1 year survival.
