Key result
Standard and oncology-specific equations fail to accurately estimate creatinine clearance in metastatic ovarian cancer.
Why the study?
The predictive performance of creatinine clearance estimation methods in patients with metastatic ovarian cancer was uncertain.
Do standard or oncology-specific equations accurately estimate measured creatinine clearance in patients with metastatic ovarian cancer?
Observational (n=14)
Do standard or oncology-specific equations accurately estimate measured creatinine clearance in patients with metastatic ovarian cancer?
Effect estimate: r = 0.38 to 0.54
Standard equations for estimating creatinine clearance are predictive of measured 24-hour values in ovarian cancer patients, and oncology-specific equations do not improve accuracy or precision.
Caution advised using standard or oncology-specific CrCl equations for dosing in metastatic ovarian cancer; leaves open need for validated alternatives.
The authors evaluated the predictive performance of four methods used to estimate creatinine clearance (Cl(cr)) in patients with metastatic ovarian cancer. Methods described by Cockcroft and Gault, Jelliffe, and two equations derived from cancer patients by Robinson and Tsubaki, were evaluated. Estimated Cl(cr) values obtained by each method using actual weight (ABW), ideal weight (IBW) and lower of ABW and IBW were compared with measured values determined by a 12- or 24-hour urine collection for 14 patients enrolled in a controlled clinical trial. The mean prediction errors (ME) and mean absolute errors (MAE) were calculated to evaluate the bias and precision, respectively, of each method. The relationship between predicted and measured Cl(cr) is poor (r = 0.38 to 0.54). Cockcroft and Gault using ABW (p = 0.21), Robinson using ABW (p = 0.44), and Jelliffe (p = 0.17) were equally unbiased predictors of measured Cl(cr). All other methods significantly underestimated measured Cl(cr). All methods appeared to be equally imprecise (p<0.05). The use of standard equations for estimating Cl(cr) in patients with ovarian cancer is predictive of the measured 24-hour value. The use of oncology specific equations does not improve the accuracy or precision of these estimates.
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Montgomery et al. (2000) conducted an observational in Metastatic ovarian cancer (n=14). Estimated creatinine clearance equations (Cockcroft-Gault, Jelliffe, Robinson, Tsubaki) vs. Measured creatinine clearance (12- or 24-hour urine collection) was evaluated on Predictive performance (bias and precision) of estimated creatinine clearance (r = 0.38 to 0.54). Standard equations for estimating creatinine clearance in metastatic ovarian cancer showed poor correlation with measured values (r = 0.38 to 0.54), and oncology-specific equations did not improve accuracy.
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