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. 2013 Oct 15;109(8):2066-71.
doi: 10.1038/bjc.2013.515. Epub 2013 Sep 24.

Montreal prognostic score: estimating survival of patients with non-small cell lung cancer using clinical biomarkers

B Gagnon  1 , J S Agulnik, I Gioulbasanis, G Kasymjanova, D Morris, N MacDonald
Affiliations

Montreal prognostic score: estimating survival of patients with non-small cell lung cancer using clinical biomarkers

B Gagnon et al. Br J Cancer. .

Abstract

Background: For evidence-based medical practice, well-defined risk scoring systems are essential to identify patients with a poor prognosis. The objective of this study was to develop a prognostic score, the Montreal prognostic score (MPS), to improve prognostication of patients with incurable non-small cell lung cancer (NSCLC) in everyday practice.

Methods: A training cohort (TC) and a confirmatory cohort (CC) of newly diagnosed patients with NSCLC planning to receive chemotherapy were used to develop the MPS. Stage and clinically available biomarkers were entered into a Cox model and risk weights were estimated. C-statistics were used to test the accuracy.

Results: The TC consisted of 258 patients and the CC consisted of 433 patients. Montreal prognostic score classified patients into three distinct groups with median survivals of 2.5 months (95% confidence interval (CI): 1.8, 4.2), 8.2 months (95% CI: 7.0, 9.4) and 18.2 months (95% CI: 14.0, 27.5), respectively (log-rank, P<0.001). Overall, the C-statistics were 0.691 (95% CI: 0.685, 0.697) for the TC and 0.665 (95% CI: 0.661, 0.670) for the CC.

Conclusion: The MPS, by classifying patients into three well-defined prognostic groups, provides valuable information, which physicians could use to better inform their patients about treatment options, especially the best timing to involve palliative care teams.

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Figures

Figure 1
Figure 1
Kaplan–Meier curves over 18 months for the CC. MPS groups: 1, 2, 3.
Figure 2
Figure 2
Results of the changes of the C-statistics over time based on Cox's PH model for the MPS based on the TC and CC.
See this image and copyright information in PMC

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