使用经过验证的预后评分对不明原发癌患者进行个体预期寿命估计。

Individual life expectancy estimation using validated prognostic scores for patients with cancer of unknown primary.

机构信息

Département de Cancérologie Générale, Centre de Lutte Contre le Cancer Oscar Lambret, Lille, France.

出版信息

Oncology. 2010;78(2):87-93. doi: 10.1159/000306137. Epub 2010 Mar 30.

DOI:10.1159/000306137

PMID:20357516

Abstract

PURPOSE

To implement 3 published prognostic scores in an independent set of patients with cancer of unknown primary (CUP), and compare their performance on individual life expectancy prediction.

PATIENTS AND METHOD

The survival of 430 consecutive patients with CUP was measured after they had allocated to their prognostic group (good prognosis vs. poor prognosis) according to each prognostic score. Using a 2 x 2 contingency table, we measured the sensitivity, specificity, positive predictive value (PPV) and accuracy of each score in predicting individual outcome (survival <90 days or >180 days).

RESULTS

The median overall survival was 189 days (1-4,801 days). Survival was <90 days in 143/421 cases and >180 days in 208/413 cases. The three PPVs were within the same range for prediction of survival <90 days (from 43 to 49%) as well as for prediction of survival >180 days (from 70 to 80%), and underestimate individual life expectancy of 40-50% of the patients. None of the 3 scores appeared significantly better.

CONCLUSION

The main finding of this retrospective analysis is that the published prognostic scores cannot be used for rational decision making.

摘要

目的

在一组独立的癌症未知原发性（CUP）患者中实施 3 种已发表的预后评分，并比较它们在个体预期寿命预测方面的性能。

患者和方法

根据每个预后评分，将 430 例连续 CUP 患者分配到预后组（预后良好组与预后不良组）后，测量其生存情况。使用 2x2 列联表，我们测量了每个评分在预测个体预后（生存<90 天或>180 天）方面的敏感性、特异性、阳性预测值（PPV）和准确性。

结果

中位总生存期为 189 天（1-4801 天）。421 例中有 143 例生存<90 天，413 例中有 208 例生存>180 天。对于生存<90 天的预测，三种 PPV 均在相同范围内（43%至 49%），对于生存>180 天的预测，PPV 也在相同范围内（70%至 80%），并且低估了 40%至 50%的患者的个体预期寿命。这 3 种评分均无显著优势。