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Clinical Predictors of Survival for Patients with Stage IV Cancer Referred to Radiation Oncology.

Kao J, Gold KD, Zarrili G, Copel E, Silverman AJ, Ramsaran SS, Ramsaran SS, Yens D, Ryu S - PLoS ONE (2015)

Bottom Line: Other).Risk group stratification was performed by assigning points for adverse prognostic factors resulting in very low, low, intermediate and high risk groups.The median survival was > 31.4 months for very low risk patients compared to 14.5 months for low risk, 4.1 months for intermediate risk and 1.2 months for high risk (p < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Good Samaritan Hospital Medical Center, Department of Radiation Oncology, West Islip, New York, United States of America.

ABSTRACT

Background: There is an urgent need for a robust, clinically useful predictive model for survival in a heterogeneous group of patients with metastatic cancer referred to radiation oncology.

Methods: From May 2012 to August 2013, 143 consecutive patients with stage IV cancer were prospectively evaluated by a single radiation oncologist. We retrospectively analyzed the effect of 29 patient, laboratory and tumor-related prognostic factors on overall survival using univariate analysis. Variables that were statistically significant on univariate analysis were entered into a multivariable Cox regression to identify independent predictors of overall survival.

Results: The median overall survival was 5.5 months. Four prognostic factors significantly predicted survival on multivariable analysis including ECOG performance status (0-1 vs. 2 vs. 3-4), number of active tumors (1 to 5 vs. ≥ 6), albumin levels (≥ 3.4 vs. 2.4 to 3.3 vs. < 2.4 and primary tumor site (Breast, Kidney or Prostate vs. Other). Risk group stratification was performed by assigning points for adverse prognostic factors resulting in very low, low, intermediate and high risk groups. The median survival was > 31.4 months for very low risk patients compared to 14.5 months for low risk, 4.1 months for intermediate risk and 1.2 months for high risk (p < 0.001).

Conclusions: These data suggest that a model that considers performance status, extent of disease, primary tumor site and serum albumin represents a simple model to accurately predict survival for patients with stage IV cancer who are potential candidates for radiation therapy.

No MeSH data available.


Related in: MedlinePlus

Overall Survival Stratified by Risk Score.Very low risk patients have a risk score of 0 to 1. Low risk patients have a risk score of 1.5 to 2. Intermediate risk patients have a risk score of 2.5 to 3.5. High risk patinets have a risk score of ≥4. Patients receive 1 point for serum albumin <2.4, ECOG performance status 2, ≥6 active tumors or primary site other than breast, kidney or prostate. Patients receive 2 points for ECOG performance status 3 to 4 and 0.5 points for serum albumin 2.4 to 3.3.
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pone.0124329.g001: Overall Survival Stratified by Risk Score.Very low risk patients have a risk score of 0 to 1. Low risk patients have a risk score of 1.5 to 2. Intermediate risk patients have a risk score of 2.5 to 3.5. High risk patinets have a risk score of ≥4. Patients receive 1 point for serum albumin <2.4, ECOG performance status 2, ≥6 active tumors or primary site other than breast, kidney or prostate. Patients receive 2 points for ECOG performance status 3 to 4 and 0.5 points for serum albumin 2.4 to 3.3.

Mentions: Composite scores ranged from 0 to 5. Composite scores were used to classify patients into 4 groups with clearly distinct median survivals (Table 5). There was a very low risk cohort with a composite score of 0 to 1 had a median survival of >31.4 months (95% confidence interval 15.5 months to not reached). The low risk cohort with a composite score of 1.5 to 2 had a median survival of 14.5 months (95% confidence interval 8.0 to 21.4 months). The intermediate risk group had a composite score of 2.5 to 3.5 had a median survival of 4.1 months (95% confidence interval 2.6 to 5.7 months). The high risk group had a composite score of 4 to 5 and had a median survival of 1.2 months (95% confidence interval 0.7 to 1.5 months). Risk group strongly predicted overall survival with a p value of <0.001 (Fig 1).


Clinical Predictors of Survival for Patients with Stage IV Cancer Referred to Radiation Oncology.

Kao J, Gold KD, Zarrili G, Copel E, Silverman AJ, Ramsaran SS, Ramsaran SS, Yens D, Ryu S - PLoS ONE (2015)

Overall Survival Stratified by Risk Score.Very low risk patients have a risk score of 0 to 1. Low risk patients have a risk score of 1.5 to 2. Intermediate risk patients have a risk score of 2.5 to 3.5. High risk patinets have a risk score of ≥4. Patients receive 1 point for serum albumin <2.4, ECOG performance status 2, ≥6 active tumors or primary site other than breast, kidney or prostate. Patients receive 2 points for ECOG performance status 3 to 4 and 0.5 points for serum albumin 2.4 to 3.3.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4404053&req=5

pone.0124329.g001: Overall Survival Stratified by Risk Score.Very low risk patients have a risk score of 0 to 1. Low risk patients have a risk score of 1.5 to 2. Intermediate risk patients have a risk score of 2.5 to 3.5. High risk patinets have a risk score of ≥4. Patients receive 1 point for serum albumin <2.4, ECOG performance status 2, ≥6 active tumors or primary site other than breast, kidney or prostate. Patients receive 2 points for ECOG performance status 3 to 4 and 0.5 points for serum albumin 2.4 to 3.3.
Mentions: Composite scores ranged from 0 to 5. Composite scores were used to classify patients into 4 groups with clearly distinct median survivals (Table 5). There was a very low risk cohort with a composite score of 0 to 1 had a median survival of >31.4 months (95% confidence interval 15.5 months to not reached). The low risk cohort with a composite score of 1.5 to 2 had a median survival of 14.5 months (95% confidence interval 8.0 to 21.4 months). The intermediate risk group had a composite score of 2.5 to 3.5 had a median survival of 4.1 months (95% confidence interval 2.6 to 5.7 months). The high risk group had a composite score of 4 to 5 and had a median survival of 1.2 months (95% confidence interval 0.7 to 1.5 months). Risk group strongly predicted overall survival with a p value of <0.001 (Fig 1).

Bottom Line: Other).Risk group stratification was performed by assigning points for adverse prognostic factors resulting in very low, low, intermediate and high risk groups.The median survival was > 31.4 months for very low risk patients compared to 14.5 months for low risk, 4.1 months for intermediate risk and 1.2 months for high risk (p < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Good Samaritan Hospital Medical Center, Department of Radiation Oncology, West Islip, New York, United States of America.

ABSTRACT

Background: There is an urgent need for a robust, clinically useful predictive model for survival in a heterogeneous group of patients with metastatic cancer referred to radiation oncology.

Methods: From May 2012 to August 2013, 143 consecutive patients with stage IV cancer were prospectively evaluated by a single radiation oncologist. We retrospectively analyzed the effect of 29 patient, laboratory and tumor-related prognostic factors on overall survival using univariate analysis. Variables that were statistically significant on univariate analysis were entered into a multivariable Cox regression to identify independent predictors of overall survival.

Results: The median overall survival was 5.5 months. Four prognostic factors significantly predicted survival on multivariable analysis including ECOG performance status (0-1 vs. 2 vs. 3-4), number of active tumors (1 to 5 vs. ≥ 6), albumin levels (≥ 3.4 vs. 2.4 to 3.3 vs. < 2.4 and primary tumor site (Breast, Kidney or Prostate vs. Other). Risk group stratification was performed by assigning points for adverse prognostic factors resulting in very low, low, intermediate and high risk groups. The median survival was > 31.4 months for very low risk patients compared to 14.5 months for low risk, 4.1 months for intermediate risk and 1.2 months for high risk (p < 0.001).

Conclusions: These data suggest that a model that considers performance status, extent of disease, primary tumor site and serum albumin represents a simple model to accurately predict survival for patients with stage IV cancer who are potential candidates for radiation therapy.

No MeSH data available.


Related in: MedlinePlus