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Liver metastasis, low hemoglobin, and poor performance status indicate shorter survival

-- Jeff Muise

Friday, March 19, 2010 (Last Updated: 03/22/2010)

FRIDAY, March 19 (HealthDay News) -- For patients with transitional cell carcinoma of the urothelial tract (TCCU) that is refractory to platinum-based therapy, prognostic factors for overall survival include liver involvement, low hemoglobin, and performance status scores, according to a study published online March 15 in the Journal of Clinical Oncology.

Joaquim Bellmunt, M.D., of the University Hospital del Mar in Barcelona, Spain, and colleagues analyzed data on 370 patients from the vinflunine clinical trial who had TCCU and a first-line treatment with a platinum-based regimen that failed. The researchers used univariate and multivariate analysis to evaluate 16 clinical, laboratory, and other prognostic factors correlated with overall survival.

The researchers found that the principal adverse prognostic factors for overall survival included an Eastern Cooperative Oncology Group performance status score of more than zero, hemoglobin level less than 10 g/dL, and liver metastasis. Among four subgroups in which there were none, one, two or three of those prognostic factors, median overall-survival times were 14.2, 7.3, 3.8 and 1.7 months, respectively.

"We identified and both internally and externally validated three adverse risk factors (performance status, hemoglobin level, and liver metastasis) that predict for overall survival and developed a scoring system that classifies patients with platinum-refractory disease on second-line chemotherapy into four risk groups with different outcome. Similar to the first-line setting, the presence of visceral metastases and poor performance status predict a worse prognosis. These factors, together with low hemoglobin, can be used for prognostication and future patient stratification in clinical trials," the authors write.

Several study authors reported financial relationships with pharmaceutical companies, including employment, leadership, advice, or honoraria.

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Specialties Oncology
OBGYN & Women's Health
Pathology

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