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Simple prognostic model for patients with advanced cancer based on performance status
Raymond W Jang1, Valerie B Caraiscos1, Nadia Swami1
1University of Toronto; and Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Journal of Oncology Practice
|August 14, 2014
Summary
Performance status scales like ECOG, PPS, and KPS effectively predict survival in advanced cancer patients. Worsening performance status consistently halved survival, with similar predictive accuracy across all three scales.
Area of Science:
- Oncology
- Palliative Care
- Biostatistics
Background:
- Accurate survival estimates are crucial for informed decision-making in cancer care.
- Performance Status (PS) scales are commonly used to assess patient condition.
Purpose of the Study:
- To provide survival estimates for advanced cancer outpatients.
- To compare the predictive abilities of Eastern Cooperative Oncology Group (ECOG), Palliative Performance Scale (PPS), and Karnofsky Performance Status (KPS) scales.
Main Methods:
- Data collected from 1,655 outpatients at Princess Margaret Cancer Centre (April 2007-February 2010).
- Survival analysis using Kaplan-Meier method and log-rank test for trend.
- Concordance index (C-statistic) assessed predictive discriminatory ability.
Main Results:
- All three PS scales (ECOG, PPS, KPS) significantly delineated survival (P < .001).
- Median survival halved with each worsening PS level.
- C-statistics were comparable across scales, ranging from 0.63 to 0.64.
Conclusions:
- Performance Status scales offer a simple yet effective tool for prognostication in advanced cancer.
- These PS scales demonstrate similar discriminatory ability to more complex prognostic models.
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