Prognostic Score of Schindl et al for a Patient with Colorectal Cancer and Liver Metastases

Parameters:

(1) Duke stage

(2) number of hepatic metastases

(3) serum alkaline phosphatase in IU/L

(4) serum CEA level in µg/L

(5) serum albumin in g/dL

where:

• The reference range for serum alkaline phosphatase was 40 - 125 IU/L.

• The reference range for serum CEA was < 5 µ/L.

• The reference range for serum albumin was 3.6 - 4.7 g/dL.

X =

= (4 * (points for Duke stage)) + (6 * (points for number of hepatic metastases)) + (6 * LN(serum alkaline phosphatase)) + (2 * LN(serum CEA)) - (serum albumin) + 22

NOTE: The addition of 22 to the score means that it is very hard to get a patient in the good prognostic group. The only way this can be achieved is by having very low values for CEA and high levels of serum albumin. I would definitely try to validate the score before using it clinically.

prognostic score =

= ROUND(X, 0)

Interpretation:

• minimum score: 0

• maximum score: > 25

• The higher the score the worse the prognosis.