1. ¹Department of Medical Oncology, National Cancer Centre, 11 Hospital Drive, Singapore 169610, Singapore
2. ²Clinical Trials and Epidemiology Research Unit, Singapore Health Services Pte Ltd, 11 Third Hospital Avenue, Singapore 168751, Singapore
3. ³Department of Therapeutic Radiology, National Cancer Centre, 11 Hospital Drive, Singapore 169610, Singapore

Correspondence: Dr E-H Tan, E-mail: dmoteh@nccs.com.sg

Received 2 December 2004; Revised 17 February 2005; Accepted 17 February 2005; Published online 5 April 2005.

Abstract

Patients with metastatic nasopharyngeal carcinoma have variable survival outcomes. We previously designed a scoring system to better prognosticate these patients. Here, we report results on validation of this new prognostic index score in a separate cohort of patients. Clinical features and laboratory parameters were examined in 172 patients with univariate and multivariate analyses and a numerical score was derived for each independent prognostic variable. Significant independent prognostic variables and their scores assigned included poor performance status (score 5), haemoglobin <12 g dl^-1 (score 4) and disease-free interval (DFI) (DFI6 months (score 10) or metastases at initial diagnosis (score 1)). Maximum score was 19 and patients stratified into three prognostic groups: good, 0–3; intermediate, 4–8; poor, 9. When applied to a separate cohort of 120 patients, 59 patients were good, 43 intermediate and 18 poor prognosis, with median survivals of 19.6 (95% CI 16.1, 23.1), 14.3 (95% CI 12.3, 16.2) and 7.9 (95% CI 6.6, 9.2) months, respectively. (logrank test: P=0.003). We have validated a new prognostic score with factors readily available in the clinics. This simple score will prove useful as a method to prognosticate and stratify patients as well as to promote consistent reporting among clinical trials.