Will we treat or let him live?

Oncologists often face a situation when it is necessary to correlate the effectiveness of treatment with the estimated survival time of a particular patient in order, based on this, to choose the most appropriate method of therapy.

The prognosis of survival will also help to avoid unjustified treatment or, conversely, situations where treatment should help, but is not prescribed.

Researchers from the Medical Center at the University of Leiden (Netherlands) have identified three factors determining the severity of patients with bone cancer metastases:

• Clinical characteristics of the primary tumor. The longest survival was with the primary localization of the tumor in the mammary gland, the location of the primary tumor in the lungs was less favorable.
• The general condition of the patient is the ability to carry out daily activities assessed according to a special Karnofsky Performance Scale.
• The presence of metastases in other organs.

Depending on the combination of these factors, patients with bone cancer metastases can be divided into several groups depending on the estimated average survival rate: 29.1 months, 10.5 months, 4.6 months and 2.2 months.

Drawings from the article by Willeumier et al.

To evaluate the test, the authors analyzed data from 1,520 patients who received symptomatic treatment for bone cancer metastases from 2000 to 2013. The average age of patients was 65 years. The most frequent localization of the primary tumor were the lungs and mammary glands. Most often, treatment was prescribed to relieve bone pain, as well as for the prevention and treatment of fractures.

The model has proven itself well when comparing the predicted survival rate of patients with the actual one.

Using this tool to assess survival will help clinicians plan management tactics for each individual patient. So, with a more favorable prognosis, it is possible to raise the question of installing implants for the treatment of fractures and restoration of motor functions. It would be more correct to prescribe palliative treatment to patients with a less favorable prognosis.

The application of the developed prognostic model, as the authors write, is another step towards personalized medicine. They have developed a special mobile application in English OPTIModel, which simplifies the use of the model.

Article by Willeumier et al. An Easy-to-Use Prognostic Model for Survival Estimation for Patients with Symptomatic Long Bone Metastases is published in the Journal of Bone and Joint Surgery.

Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru based on EurekAlert materials: New tool helps physicians estimate survival for patients with cancers that have spread to bone.