Clinical calculator summary
Original 1998 CALGB Mesothelioma Prognostic Groups
Clinical calculator summary
Original 1998 CALGB Mesothelioma Prognostic Groups
A six-terminal recursive classification using ECOG, age, hemoglobin, WBC, chest pain, and weight loss.
Evidence-based context for fast calculator use
- Purpose:
- Reproduce the published CALGB prognostic group for an eligible historical-model case.
- Population:
- Adults with advanced malignant mesothelioma entering chemotherapy trials in the original CALGB cohort.
- Factors:
- ECOG performance status, Age, Hemoglobin, White blood cell count, Chest pain, Weight loss greater than 5%
- Reference:
- Herndon et al. Chest. 1998;113(3):723-731.
Mesothelioma CALGB Score
Clinical Context & Background
Original 1998 Herndon CALGB six-group recursive partition: ECOG 0 branches by age 49 years and hemoglobin 14.6 g/dL; ECOG 1-2 branches by WBC 8.7, 9.8, and 15.6 x10^9/L, chest pain, weight loss >5%, and hemoglobin 11.2 or 12.3 g/dL.Reference Data
| CALGB group | Original branch criteria | Historical median survival (95% CI) |
|---|---|---|
| Group 1 | ECOG 0 and age <49; or ECOG 0, age >=49, hemoglobin >=14.6 g/dL | 13.9 months (11.1-31.4) |
| Group 2 | ECOG 1-2, WBC <8.7 x10^9/L, no chest pain | 9.5 months (6.9-14.7) |
| Group 3 | ECOG 0, age >=49, hemoglobin <14.6; or specified ECOG 1-2 chest-pain branches meeting hemoglobin thresholds | 9.2 months (7.5-10.5) |
| Group 4 | ECOG 1-2, WBC 8.7 to <15.6 x10^9/L, no chest pain | 6.5 months (3.7-9.4) |
| Group 5 | ECOG 1-2, WBC <15.6, chest pain, and the adverse weight-loss/hemoglobin branch | 4.4 months (3.4-5.1) |
| Group 6 | ECOG 1-2 and WBC >=15.6 x10^9/L | 1.4 months (0.5-3.6) |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use only for an adult with advanced malignant mesothelioma when all six source variables are explicitly available.
- Apply the original raw thresholds without rounding laboratory values first.
How To Interpret
- The six groups reproduce terminal branches in the 1998 CALGB recursive tree.
- Displayed survival medians and confidence intervals describe the historical source cohort rather than an individual contemporary patient.
What To Do Next
- Document the source-era variables and resulting historical group.
- Integrate current pathology, stage, treatment history, performance status, molecular findings, comorbidity, and multidisciplinary guidance separately.
Limitations
- The original cohort included 337 chemotherapy-trial patients accrued from 1984 through 1994.
- Localized surgical disease, recurrent or previously treated disease, and modern systemic-treatment outcomes are not represented.
- This calculator does not stage disease or provide treatment recommendations.
Validated Population
Adults with advanced malignant mesothelioma entering CALGB chemotherapy trials, without previous chemotherapy, in the historical derivation cohort.
Published threshold example
For ECOG 1, WBC 8.70 x10^9/L, and no chest pain, the case enters Group 4 rather than Group 2 because the Group 2 WBC branch is strictly below 8.7.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed CALGB cases passed through visible production controls across Groups 1, 4, and the Group-6 WBC boundary.
- No unexpected N/A, literal undefined value, stale control, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/calgb-mesothelioma-prognostic-model-2026-08-03.json.
: Local browser remediation verified; production retest pending
- Ten source-backed cases passed through visible controls across 11 submissions, covering all six terminal groups, raw threshold transitions, required-field validation, and reset/repeat.
- Every valid result displayed six defined decision-tree rows using neutral published-rule wording; no literal undefined value appeared.
- The original production UI and hydration findings remain open until deployment and public revalidation.
Case-level local remediation evidence is retained in validation/browser-production/calgb-mesothelioma-prognostic-model.local-remediation.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 1/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
- Overall browser status: failed-ui-and-console. high: Every valid CALGB result displayed six bold literal `undefined` values, one beneath each decision-tree trace row, even though the group and historical outcome were correct. | medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/calgb-mesothelioma-prognostic-model.json.
: Browser input adapter corrected and reverified
- Accepted finite number values already normalized by the shared calculator form while retaining strict malformed-input rejection.
- No equation, cutoff, unit, classification, or applicability rule changed; calculator-specific verification and the calculator-wide browser-input audit passed.
: Full validation test
- 2,048/2,048 independent source-branch, cross-product, boundary, invalid-input, UI, outcome, trace, scope, registry, report, and isolation checks passed.
- No registered master panel calculates this CALGB model or inherits its verification status.
: Calculation and input-contract correction
- Replaced the nonpublished simplified model with the original 1998 Herndon six-group recursive tree and exact historical median-survival observations and confidence intervals.
- Removed unsupported histology, LDH, platelet, and age-above-75 inputs; now requires explicit ECOG, adult age, hemoglobin, WBC, chest-pain, and weight-loss assessments without coercion or favorable defaults.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Related Tools
Frequently Asked Questions
Is this the original published CALGB model?
Yes. It implements the 1998 Herndon six-group recursive tree. Histology, LDH, platelet count, and an age-above-75 flag are not inputs in the published final tree.
Are the survival values personal predictions?
No. They are historical cohort medians and 95% confidence intervals from chemotherapy trials conducted in an earlier treatment era.
Does a CALGB group determine treatment?
No. The group is a historical prognostic classification and must not be used alone to select treatment, staging, surveillance, or trial eligibility.
Evidence-based oncology decision support. Verify with clinical guidelines.