Use of the Graded Prognostic Assessment (GPA) for a Patient with Brain Metastases from Malignant Melanoma or Renal Cell Carcinoma

Description

Sperduto et al developed the Graded Prognostic Assessment (GPA) to evaluate patients with brain metastases (see 27.54.46). Later different scores were developed for various primary sites. The authors are from the University of Minnesota and Ridgeview Medical Center in Minnesota.

Patient selection: malignant melanoma or renal cell carcinoma

Parameters:

(1) Karnofsky Performance Scale (KPS)

(2) number of metastases to the central nervous system (CNS)

Parameter	Finding	Points
KPS	90 or 100	2
	70 or 80	1
	<= 60	0
number of CNS metastases	1	2
	2 or 3	1
	4 or more	0

total GPA =

= SUM(points for both parameters)

Interpretation:

• minimum score: 0

• maximum score 4

• The higher the GPA the better the prognosis.

GPA	Median Survival Time for Melanoma	Median Survival for Renal Cell Carcinoma
0, 0.5, 1.0	3.5 months	3.3 months
1.5, 2.0 or 2.5	4.7 months	7.3 months
3.0	8.8 months	11.3 months
3.5 or 4.0	13.2 months	14.8 months

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Description

Specialty

ICD-10