Yamamoto et al developed a prognostic index for women with metastatic breast cancer. This can identify women with different risk characteristics, which can aid in making therapeutic decisions. The authors are from the National Shikoku Cancer Center Hospital in Matsuyama, Japan.
Parameters:
(1) adjuvant chemotherapy
(2) distant lymph node metastasis
(3) liver metastasis
(4) serum LDH
(5) disease free interval
Parameter |
Finding |
Points |
adjuvant chemotherapy |
not received |
0 |
|
received |
1 |
distant lymph node metastasis |
absent |
0 |
|
present |
1 |
liver metastasis |
absent |
0 |
|
present |
1 |
serum LDH |
<= upper limit of normal (<= 1 times normal) |
0 |
|
> upper limit of normal (> 1 times normal) |
1 |
disease free interval |
>= 24 months |
0 |
|
< 24 months |
2 |
where:
• Receipt of adjuvant chemotherapy was associated with lower mean survival time.
prognostic index =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the index, the higher the risk.
Index |
Risk Group |
Mean Survival Time in Months |
95% CI |
0 or 1 |
low |
45.5 |
38.8 – 52.3 |
2 or 3 |
intermediate |
24.6 |
18.2 – 31.0 |
4, 5 or 6 |
high |
10.6 |
2.9 – 18.2 |
from Table 5, page 2405, for the initial study population
Limitation:
• The disease free interval may limit the use of the index. It would be useful for a woman with an early relapse, or in a woman with other risk factors. Otherwise you would need to wait 2 years before the index could be calculated.
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
ICD-10: ,