Performance status assessment in cancer patients

Conill, Carlos; Verger, E.; Salamero, Manuel

doi:10.1002/1097-0142(19900415)65:8<1864::aid-cncr2820650832>3.0.co;2-u

Cited by 254 publications

(137 citation statements)

References 9 publications

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“…It includes variables related to tumor stage, liver functional status, physical status and cancer related symptoms. [189][190][191] The main advantage of the BCLC staging system is that it links staging with treatment modalities and with an estimation of life expectancy that is based on published response rates to the various treatments. It identifies those with early HCC who may benefit from curative therapies, those at intermediate or advanced disease stage who may benefit from palliative treatments, as well as those at end-stage with a very poor life expectancy ( Fig.…”

Section: Staging Systemsmentioning

confidence: 99%

“…Patients who present with a more advanced stage because of liver failure or tumor growth with vascular involvement/extrahepatic spread or physical impairment reflected by a markedly impaired performance status (Ͻ2) [189][190][191] will not benefit from any treatment option, even one with known efficacy in earlier disease. Accordingly, the optimal policy for these subjects is to attempt to enroll them in research studies testing new agents either within phase 2 investigations or within RCT.…”

Section: Treatment Algorithmmentioning

confidence: 99%

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Management of Hepatocellular Carcinoma *

2005

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Section: Staging Systemsmentioning

confidence: 99%

Section: Treatment Algorithmmentioning

confidence: 99%

Management of Hepatocellular Carcinoma *

2005

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“…In contrast, three previous papers report on the inter-observer variability in the use of Karnofsky Performance Status Scale (Schag et al, 1984;Yates et al, 1980;Hutchinson et al, 1979). No (Conill et al, 1990).…”

mentioning

confidence: 94%

Performance status assessment in cancer patients. An inter-observer variability study

Sørensen

Klee²,

Palshof³

et al. 1993

Br J Cancer

409

255

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Summary The ECOG Scale of Performance Status (PS) is widely used to quantify the functional status of cancer patients, and is an important factor determining prognosis in a number of malignant conditions. The PS describes the status of symptoms and functions with respect to ambulatory status and need for care. PS 0 means normal activity, PS 1 means some symptoms, but still near fully ambulatory, PS 2 means less than 50%, and PS 3 means more than 50% of daytime in bed, while PS 4 means completely bedridden. An inter-observer variability study of PS assessment has been carried out to evaluate the non-chance agreement among three oncologists rating 100 consecutive cancer patients. Total unanimity was observed in 40 cases, unanimity between two observers in 53 cases, and total disagreement in seven cases. Kappa statistics reveal the ability of the observers compared to change alone and were used to evaluate non-chance agreement. Overall Kappa was 0.44, (95% confidence limits 0.38-0.51). The Kappa for PS 0 was 0.55 (0.44-0.67), while those for PS 1, 2, 3 and four were 0.48 (0.37-0.60), 0.31 (0.19-0.42), 0.43 (0.32-0.55), and 0.33 (0.33-0.45), respectively. If one observer allocated patients to PS 0-2, then another randomly selected observed placed the patients in the same category with a probability of 0.92. For patients with PS 3-4 the probability that the same category would be chosen was 0.82. Overall, the non-chance agreement between observers was only moderate, when all ECOG Performance Status groups were considered. However, agreement with regard to allocation of patients to PS 0-2 versus 3-4 was high. This is of interest because this cut-off is often used in clinical studies.

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“…The patient's Eastern Cooperative Oncology Group (ECOG) performance status was rated at each interview. 25 Treatments were classifi ed as follows: surgery, considered to be any invasive approach related to the metastatic sites, but not including procedures only used for diagnosis; chemotherapy, including the use of anti-cancer drugs administered by any means; hormonal treatment, i.e. chemical endocrine therapy; radiotherapy, including any form of application; and fi nally, clinical support, defi ned as any other medical intervention not included in the preceding items.…”

Section: Methodsmentioning

confidence: 99%

Metastatic breast cancer: do current treatments improve quality of life? A prospective study

2006

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CONTEXT AND OBJECTIVE: In metastatic breast cancer cases, the currently available therapeutic approaches provide minimal improvement in survival. As such, quality of life (QOL) becomes one of the main objectives of treatment. It is not known whether current treatments derived from trials improve QOL. The aim was to evaluate changes in QOL among metastatic breast cancer patients receiving treatment derived from trials. DESIGN AND SETTING: Prospective observational QOL survey in a tertiary cancer center. METHODS: To evaluate the influence of current treatments on patients' QOL, the Medical Outcomes Study Short Form-36 (SF-36) and the Beck Depression Inventory (BDI) were applied on three occasions: before starting treatment and at the 6th and 12th weeks, to consecutive metastatic breast cancer patients over a one-year period. RESULTS: We found an improvement in QOL in the sample evaluated (n = 40), expressed by changes in the overall SF-36 score (p = 0.002) and the BDI (p = 0.004). Taken individually, the SF-36 components Pain, Social Functioning and Mental Health also improved significantly. Patients with worse initial performance status and secondary symptoms displayed greater improvement than those with better initial performance status and asymptomatic disease (p < 0.001). Patients who received more than one type of therapy showed larger gains than those given only one type (p = 0.038). CONCLUSIONS: In our environment, current metastatic breast cancer treatments can improve QOL, especially among symptomatic patients and those with low performance status.

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Performance status assessment in cancer patients

Cited by 254 publications

References 9 publications

Management of Hepatocellular Carcinoma *

Management of Hepatocellular Carcinoma *

Performance status assessment in cancer patients. An inter-observer variability study

Metastatic breast cancer: do current treatments improve quality of life? A prospective study

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