Application of Royal Marsden Hospital Prognostic score to our dataset. The model includes LDH >618 IU/L, albumin <3.5 mg/dL, and number of metastatic sites >2. Each variable was assigned one point with scores of 3 considered high risk and score of 0 being lowest. The median survival of subjects with score of 0 (low risk), 1 (low-intermediate risk), 2 (intermediate risk), and 3 (high risk) was 9.4, 6.6, 6.7, and 3.7 months, respectively (P<0.0001).