Development and validation of a prognostic model to predict the length of survival in patients with carcinomas of an unknown primary site
Development and validation of a prognostic model to predict the length of survival in patients with carcinomas of an unknown primary site
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DOI：
10.1200/jco.2002.04.019
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发表时间：
2002-12-15
影响因子：
45.3
通讯作者：
Fizazi, K
中科院分区：
文献类型：
--
作者：
Culine, S;Kramar, A;Fizazi, K
目的：确定对原发部位未知的癌患者的生存有显著影响的临床和生物学变量，并为前瞻性临床试验中患者的选择建立一个简单的预后模型。患者和方法：在150名未选择的患者中进行单因素和多因素预后因素分析，并构建了两个连续的分类方案。采用两项前瞻性试验的116例患者的外部数据集进行验证。结果：当仅研究临床变量时，多变量分析中仍保留表现不佳（2或3）和肝转移的存在。第一种分类方案包括三个亚组，根据不良预后因素的数量，中位生存期分别为10.8个月、6.0个月和2.4个月。随着进一步引入血清乳酸脱氢酶（LDH）水平，肝转移不再显著。因此，第二种分类方案包括表现不佳（相对危险度[RR]， 2.1）和血清LDH水平升高（RR, 2.1）。高危患者和低危患者的中位生存期分别为11.7个月和3.9个月(P
Purpose: To identify clinical and biologic variables with significant impact on survival in patients with carcinomas of an unknown primary site and to develop a simple prognostic model for the selection of patients in prospective clinical trials.Patients and Methods: Univariate and multivariate prognostic factor analyses were conducted in a population of 150 unselected patients and led to the construction of two successive classification schemes. An external data set of 116 patients enrolled onto two prospective trials was used for validation.Results: When studying clinical variables only, poor performance status (2 or 3) and presence of liver metastases were retained in the multivariate analysis. The first classification scheme consisted of three subgroups of patients with median survivals of 10.8, 6.0, and 2.4 months, according to the number of adverse prognostic factors. With the introduction of serum lactate dehydrogenase (LDH) levels in a further step, liver metastases were no longer significant. The second classification scheme therefore included poor performance status (relative risk [RR], 2.1) and elevated serum LDH level (RR, 2.1). Good-risk and poor-risk patients were identified, with median survivals of 11.7 months and 3.9 months, respectively (P