title: Clinical Predictors of Survival for Patients with Stage IV Cancer Referred to Radiation Oncology.
abstract: BACKGROUND
  There is an urgent need for a robust, clinically useful predictive model for survival in a heterogeneous group of patients with metastatic cancer referred to radiation oncology.
  
  
  METHODS
  From May 2012 to August 2013, 143 consecutive patients with stage IV cancer were prospectively evaluated by a single radiation oncologist. We retrospectively analyzed the effect of 29 patient, laboratory and tumor-related prognostic factors on overall survival using univariate analysis. Variables that were statistically significant on univariate analysis were entered into a multivariable Cox regression to identify independent predictors of overall survival.
  
  
  RESULTS
  The median overall survival was 5.5 months. Four prognostic factors significantly predicted survival on multivariable analysis including ECOG performance status (0-1 vs. 2 vs. 3-4), number of active tumors (1 to 5 vs. ≥ 6), albumin levels (≥ 3.4 vs. 2.4 to 3.3 vs. < 2.4 and primary tumor site (Breast, Kidney or Prostate vs. Other). Risk group stratification was performed by assigning points for adverse prognostic factors resulting in very low, low, intermediate and high risk groups. The median survival was > 31.4 months for very low risk patients compared to 14.5 months for low risk, 4.1 months for intermediate risk and 1.2 months for high risk (p < 0.001).
  
  
  CONCLUSIONS
  These data suggest that a model that considers performance status, extent of disease, primary tumor site and serum albumin represents a simple model to accurately predict survival for patients with stage IV cancer who are potential candidates for radiation therapy.
authors.affiliation: Good Samaritan Hospital Medical Center, Department of Radiation Oncology, West Islip, New York, United States of America.
authors.forename: Johnny
authors.initials: J
authors.lastname: Kao
authors.affiliation: Good Samaritan Hospital Medical Center, Division of Hematology and Medical Oncology, West Islip, New York, United States of America.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Gold
authors.affiliation: Good Samaritan Hospital Medical Center, Division of Palliative Medicine, West Islip, New York, United States of America.
authors.forename: Gina
authors.initials: G
authors.lastname: Zarrili
authors.affiliation: Good Samaritan Hospital Medical Center, Division of Palliative Medicine, West Islip, New York, United States of America.
authors.forename: Emily
authors.initials: E
authors.lastname: Copel
authors.affiliation: Good Samaritan Hospital Medical Center, Department of Radiation Oncology, West Islip, New York, United States of America.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Silverman
authors.forename: Shanta S
authors.initials: SS
authors.lastname: Ramsaran
authors.affiliation: Good Samaritan Hospital Medical Center, Department of Radiation Oncology, West Islip, New York, United States of America.
authors.forename: Shanata S
authors.initials: SS
authors.lastname: Ramsaran
authors.affiliation: New York College of Osteopathic Medicine, Dept of Educational Development and Assessment, Old Westbury, New York, United States of America.
authors.forename: David
authors.initials: D
authors.lastname: Yens
authors.affiliation: Stony Brook University Medicine, Department of Radiation Oncology, Stony Brook, New York, United States of America.
authors.forename: Samuel
authors.initials: S
authors.lastname: Ryu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009369:Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018787:Radiation Oncology / Q000379:methods*; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome