Your activity: 51 p.v.
your limit has been reached. plz Donate us to allow your ip full access, Email: sshnevis@outlook.com

Clinical characteristics of patients with a variety of tumor types and a median survival of 6 months or less

Clinical characteristics of patients with a variety of tumor types and a median survival of 6 months or less
Solid cancer by site Clinical factors
Breast cancer
Any metastatic breast carcinoma with one or more of the following presentations:

KPS <60 (ECOG performance status >2)

Serum calcium >11.2 mg/dL

Epidural spinal cord compression with decreased ability to walk

Serum C-reactive protein >10 mg/L and serum albumin <3.5 g/dL

Peritoneal or leptomeningeal metastases
Any metastatic breast carcinoma with three or more of the following presentations:

KPS <80 (ECOG performance status ≥2)

Serum LDH >500 international units/L

Any liver metastasis

At least 2 sites of metastases

Disease-free interval from initial presentation to metastatic disease of <24 months

Recurrent or refractory disease after initial chemotherapy

Estrogen receptor-negative/progesterone receptor-negative tumor
Metastatic breast carcinoma with brain metastases and one or more of the following presentations:

KPS <80 (ECOG performance status ≥2)

≥2 brain metastases plus extracranial metastases

Tumor both estrogen receptor and progesterone receptor-negative
Primary brain cancer
Glioblastoma with one or more of the following presentations:

KPS <70 (ECOG performance status ≥2)

Suboptimal surgical resection or unresectable disease

Progressive or refractory disease despite initial treatment (unresponsive to treatment)
Glioblastoma with two or more of the following presentations:

KPS <90 (ECOG performance status ≥1)

Age >55 years

Recurrent disease after initial treatment

Lesion in critical hemispheric brain region

Tumor volume >50 cm3 prior to resection

Hemoglobin <12 g/dL

Platelet count > upper limit normal
Digestive system neoplasms
Colorectal cancer
Metastatic colorectal cancer with one or more of the following presentations:

KPS <70 (ECOG performance status ≥2)

Age >75 years

Brain metastases with KPS <80, age >70 years, extracranial metastases, or ≥2 brain lesions
Metastatic colorectal carcinoma with two or more of the following presentations:

KPS <90 (ECOG performance status ≥1)

Peritoneal carcinomatosis

>2 metastatic sites

Malignant ascites

Chemotherapy - refractory disease
Esophageal and gastric cancers
Locally advanced or metastatic esophageal or gastric cancer with one or more of the following presentations:

KPS <80 (ECOG performance status >1)

Recurrent or refractory disease, with disease-free interval <6 months
Locally advanced or metastatic esophageal or gastric cancer with two or more of the following presentations:

KPS <90 (ECOG performance status ≥1)

Liver metastases

Peritoneal metastases

Serum alkaline phosphatase >100 units/L

Serum LDH >200 international units/L

Serum hemoglobin <11 g/dL
Hepatobiliary and pancreatic cancers
Locally advanced or metastatic cholangiocarcinoma, gallbladder carcinoma, or pancreatic cancer with one or more of the following presentations:

KPS <90 (ECOG performance status ≥1)

Biliary obstruction with jaundice

Recurrent or refractory disease after initial chemotherapy

Liver, peritoneal, or distant metastases

Portal vein thrombosis or other vascular invasion

Gross residual disease (visible cancer) after resection

Poorly differentiated or infiltrating disease

Serum albumin <3.5 g/dL or >10% weight loss

Serum LDH >500 international units/L

Episode of extremity venous thromboembolism or pulmonary embolization

Malignant ascites
Any hepatocellular carcinoma with one or more of the following presentations:

KPS <60 (ECOG performance status >2)

End-stage cirrhosis

Large tumor size (maximum tumor diameter >10 cm or tumor volume >70% liver volume)

Any brain metastasis
Unresectable locally advanced or metastatic hepatocellular carcinoma with two or more of the following presentations:

KPS <90 (ECOG performance status ≥1)

Extrahepatic metastases

Moderate to severe symptomatic cirrhosis (eg, jaundice, ascites, fatigue, or bleeding)

Alpha-fetoprotein level ≥400 ng/mL

Portal vein thrombosis
Head and neck neoplasms
Recurrent, refractory, or metastatic head and neck squamous cell carcinoma with one or more of the following presentations:

KPS <90 (ECOG performance status ≥1)

Recurrence of disease with any metastases >10% weight loss

Muscle invasion or residual tumor at primary site

Pretreatment hemoglobin <11 g/dL

Serum calcium >11.2 mg/dL
Melanoma
Advanced or metastatic melanoma with one or more of the following presentations:

KPS <80 (ECOG performance status ≥2)

Serum LDH >2 x the upper limit of normal

Serum calcium >11.2 mg/dL

Metastasis to the brain or spine

Metastases to liver and one other site
Non-small cell lung cancer
Any locally advanced or metastatic non-small cell lung cancer with one or more of the following presentations:

KPS <70 (ECOG performance status >2)

Weight loss of >5% or serum albumin <3 g/dL

Liver metastases

Bone or bone marrow metastases

Brain metastases with neurological symptoms, KPS <70, age >65 years, or extracranial metastases

Pericardial effusion

Pleural effusion with evidence of distant metastases

Serum hemoglobin <12 g/dL

Serum calcium >11.2 mg/dL

Age >70 years with pleural effusion, hypoalbuminemia, elevated serum lactate dehydrogenase, or hyponatremia (levels outside the normal range)
Urogenital neoplasms
Female genital neoplasms
Locally advanced or metastatic ovarian, uterine endometrial, or uterine cervical cancer with regional or distant spread, and one or more of the following presentations:

KPS <60 (ECOG performance status >2)

Serum calcium >11.2 mg/dL

Brain metastases plus extracranial lesion or KPS <70 or ≥2 brain metastases

Intestinal obstruction without successful repair, or urinary tract obstruction with stent placement

Unresectable disease due to location of disease or comorbid illness
Locally advanced or metastatic ovarian, uterine endometrial or uterine cervical cancer with regional or distant spread, and two or more of the following presentations:

KPS <80 (ECOG performance status >1)

Recurrent or refractory disease (unresponsive to treatment)

Disease-free interval from diagnosis to disease recurrence or persistence of <6 months

Suboptimal resection with bulky residual disease

Significant weight loss (>5%)

Extra-abdominal metastases
Prostate cancer
Hormone-refractory metastatic prostate cancer with one or more of the following presentations:

KPS <60 (ECOG performance status >2)

KPS <80 (ECOG performance status >1) or significant fatigue, plus hemoglobin <12 g/dL

Hemoglobin <10 g/dL

Spinal cord compression with decreased ambulation
Bladder and renal cell carcinoma
Locally advanced or metastatic bladder or renal cell carcinoma with one or more of the following presentations:

KPS <70 (ECOG performance status >2)

Brain metastases with ≥2 metastases, or extracranial metastases

Serum calcium >11.2 mg/dL
Locally advanced or metastatic bladder or renal cell carcinoma with three or more of the following presentations:

KPS <80 (ECOG performance status ≥2)

Hemoglobin <11.5 g/dL

Serum LDH >300 international units/L or alkaline phosphatase >220 units/L

Disease-free interval from initial presentation to metastatic disease or disease progression ≤1 year

Visceral metastases
Presentations associated with a median survival of six months or less.
KPS: Karnofsky Performance Status; ECOG: Eastern Cooperative Oncology Group. LDH: lactate dehydrogenase.
Modified with permission from: Salpeter SR, Malter DS, Luo EJ, et al. Systematic review of cancer presentations with a median survival of six months or less. J Palliat Med 2012; 15:175. Copyright © 2012 Mary Ann Liebert, Inc.
Graphic 87452 Version 6.0