The B12/CRP index as a simple prognostic indicator in patients with advanced cancer: a confirmatory study.
BACKGROUND
The vitamin B(12)/C-reactive protein Index (BCI) has been proposed as a prognostic indicator in patients with advanced cancer. The purpose of this study was to confirm the utility of the BCI in palliative care patients.


METHODS
Patients with advanced cancer provided a blood specimen for analysis. Demographic and disease-related variables were recorded. Patients were followed up for at least 90 days or until death.


RESULTS
Patients (n = 329) were divided into three groups according to their BCI score. Patients in group 3 (BCI >40,000; median survival 29 days) had a significantly (P < 0.01) worse survival than patients in group 2 (BCI 10,001-40,000; median survival 43 days) and patients in group 1 (BCI < or =10,000; median survival 71 days). However, patients in group 1 did not have a significantly better prognosis than those in group 2 (P = 0.091). The point estimates for 90-day mortality for each of the three risk groups were different from the figures previously reported during the development phase of the BCI (group 1, 58.9% versus 47.2%; group 2, 64.0 versus 72.5%; group 3, 78.9% versus 90.6%).


CONCLUSIONS
An elevated BCI (>40,000) predicts poor survival in patients with advanced cancer.
Kelly
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Palliative Medicine, Surrey and Sussex Healthcare NHS Trust, Surrey, UK. laura.kelly@sash.nhs.uk
White
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Stone
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PC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000401:mortality*; D010166:Palliative Care; D011237:Predictive Value of Tests; D011379:Prognosis; D014805:Vitamin B 12 / Q000097:blood*
D002097:C-Reactive Protein; D014805:Vitamin B 12