Annals of Oncology Advance Access originally published online on May 19, 2007
Annals of Oncology 2007 18(8):1395-1399; doi:10.1093/annonc/mdm138
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© 2007 European Society for Medical Oncology
palliative care |
The B12/CRP index as a simple prognostic indicator in patients with advanced cancer: a confirmatory study
1 Palliative Medicine, Surrey and Sussex Healthcare NHS Trust
2 Division of Mental Health, St George's University of London, UK
* Correspondence to: Dr L. Kelly, Surrey and Sussex Healthcare NHS Trust, Canada Avenue, Redhill, Surrey RH1 5RH, UK. Tel: +44-1737-768511 ext. 2660; Fax: +44-1737-231949; E-mail: laura.kelly{at}sash.nhs.uk
Background: The vitamin B12/C-reactive protein Index (BCI) has been proposed as a prognostic indicator in patients with advanced cancer. The purpose of this study was to confirm the utility of the BCI in palliative care patients.
Patients and methods: Patients with advanced cancer provided a blood specimen for analysis. Demographic and disease-related variables were recorded. Patients were followed up for at least 90 days or until death.
Results: Patients (n = 329) were divided into three groups according to their BCI score. Patients in group 3 (BCI >40 000; median survival 29 days) had a significantly (P < 0.01) worse survival than patients in group 2 (BCI 10 001–40 000; median survival 43 days) and patients in group 1 (BCI 
10 000; median survival 71 days). However, patients in group 1 did not have a significantly better prognosis than those in group 2 (P = 0.091). The point estimates for 90-day mortality for each of the three risk groups were different from the figures previously reported during the development phase of the BCI (group 1, 58.9% versus 47.2%; group 2, 64.0 versus 72.5%; group 3, 78.9% versus 90.6%).
Conclusions: An elevated BCI (>40 000) predicts poor survival in patients with advanced cancer.
Key words: C-reactive protein, neoplasms, palliative care, prognosis, survival, vitamin B12
Received for publication December 15, 2006. Revision received March 16, 2007. Accepted for publication March 23, 2007.
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