title: Validation of prognostic scores for survival in cancer patients beyond first-line therapy.
abstract: BACKGROUND
  We aimed to validate prognostic scores for survival in patients undergoing chemotherapy for advanced or metastatic cancer after first-line treatment.
  
  
  METHODS
  We previously described two models with good prognostic value based on a combination of Performance Status (PS) and either lactate dehydrogenase (LDH) level or lymphocyte count. These factors were evaluated for their ability to predict overall survival (OS) in a prospective cohort of 299 patients. Clinical and blood parameters were prospectively recorded. Candidate prognostic factors for OS with 0.05 significance level in univariate analysis were included in a multivariate Cox model.
  
  
  RESULTS
  Median age was 59 years (range: 26-85). Primary tumor sites were breast (45%), lung (15%), ovaries (11%) and others (29%). The number of metastatic sites was 1 (29%), 2 (48%), >2 (23%). Median follow-up and median OS were 12 and 6 months, respectively. Multiple regression analysis confirmed that PS >1, lymphocyte count ≤700/μL and LDH >600 UI/L were independent predictors of short OS, as well as interleukin 6 (IL-6) level, serum albumin concentration and platelet count.
  
  
  CONCLUSIONS
  Prognostic scores using PS plus LDH level or PS plus lymphocyte count were validated for predicting survival in metastatic cancer patients in relapse beyond first-line treatment. A score combining PS, LDH, lymphocyte and platelet count, serum albumin and IL-6 level was superior in determining patients' prognosis.
authors.affiliation: Université de Lyon, Centre Léon Bérard, Department of Medical Oncology, 28 rue Laennec, 69008 Lyon, France. tredan@lyon.fnclcc.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Trédan
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ray-Coquard
authors.forename: Gisèle
authors.initials: G
authors.lastname: Chvetzoff
authors.forename: Paul
authors.initials: P
authors.lastname: Rebattu
authors.forename: Agathe
authors.initials: A
authors.lastname: Bajard
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chabaud
authors.forename: David
authors.initials: D
authors.lastname: Pérol
authors.forename: Chadi
authors.initials: C
authors.lastname: Saba
authors.forename: Florent
authors.initials: F
authors.lastname: Quiblier
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Blay
authors.forename: Thomas
authors.initials: T
authors.lastname: Bachelot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D015203:Reproducibility of Results; D012107:Research Design; D016019:Survival Analysis