Paesmans et al evaluated prognostic features for patients with advanced non-small cell carcinomas of the lung. These can help identify patients who may benefit from more aggressive management. The authors are from the European Lung Cancer Working Party.
Patient selection:
(1) non-small cell carcinoma (squamous cell, adenocarcinoma, large cell undifferentiated)
(2) nonresectable disease
(3) Karnofsky performance index >= 60 (page 1222)
Parameters:
(1) Karnofsky performance index
(2) gender
(3) disease extent (limited vs disseminated). Limited disease is Stages I to III; disseminated is Stage IV.
(4) weight loss
(5) white blood cell count (WBC count, abnormal if greater than the upper limit of the normal reference range, which was 10,000 per µL in the study)
(6) neutrophil count (abnormal if > 75%)
|
Disease Extent |
Karnofsky Index |
Other |
Group |
|
limited |
>= 80 |
female |
I |
|
limited |
>= 80 |
male |
II |
|
limited |
<= 70 |
NA |
III |
after Figure 2 and Table 5
|
Disease Extent |
Karnofsky Index |
Other |
Group |
|
disseminated |
NA |
normal WBC count, normal neutrophil count, weight loss <= 5% |
II |
|
disseminated |
NA |
normal WBC count, normal neutrophil count, weight loss > 5% |
III |
after Figure 2 and Table 5
|
Disease Extent |
Karnofsky Index |
Other |
Group |
|
disseminated |
>= 80 |
abnormal WBC count |
III |
|
disseminated |
<= 70 |
abnormal WBC count, normal neutrophil count |
III |
|
disseminated |
<= 70 |
abnormal WBC count, abnormal neutrophil count |
IV |
after Figure 2 and Table 5
|
Group |
1 Year Survival |
2 Year Survival |
Mean Survival in Years |
|
I |
53% |
27% |
1.15 |
|
II |
38% |
11% |
0.73 |
|
III |
21% |
5% |
0.50 |
|
IV |
10% |
2% |
0.27 |
Specialty: Hematology Oncology, Surgery, general, Pulmonology
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