Source: Annual Congress 2009 - Epidemiology and management of lung cancer
Disease area: Thoracic oncology

Abstract

Background: Performance scores (PS) have prognostic implications in lung cancer. At James Cook University Hospital (JCUH) Middlesbrough UK they are integral to treatment planning by the Lung Cancer Multi-Disciplinary Team. The purpose of this study was to assess reliability and impact on treatment of PS in a lung cancer clinic.
Methods: From Jan-July 2008 Karnofsky (KN-PS) and WHO-PS were recorded in patients at first appointment for suspected lung cancer. Scores were recorded independently by physician (PH), specialist nurse (SN) and patient (PT). Correlation between KN-PS/WHO-PS, inter-rater (IR) agreement and impact on treatment was assessed.
Results: Of 98 patients final diagnosis was: NSCLC 45, SCLC 8, Mesothelioma 2, Other cancer 5, Lymphoma 3, non-cancer 35. Age (lung cancer only) mean (SD) 67(10) yrs, male 58.2%. Correlation WHO-PS/KN-PS was good (PH r = -0.91; SN r = -0.86; PT r = -0.66; p<0.001). IR agreement (%) for WHO-PS was moderate for PH/SN (63% Kappa (K) 0.41); fair for SN/PT (61% K 0.3); poor for PH/PT (49% K 0.02): IR agreement for KN-PS was fair (PH/SN 38% K 0.26; PH/PT 38% K 0.23; SN/PT 44% K 0.26). A decision for nonsurgical/non-chemotherapy treatment was associated with KN-PS < 50% (100% v 38% RR 2.62 (1.7-4.1) p< 0.05), WHO-PS >2 (100% v 28% RR 3.6 (2.1-6.1) p<0.05) for all stages of disease.
Conclusions:
1. There is close correlation between WHO-PS and KN-PS in patients with suspected lung cancer;WHO-PS has greater inter-rater agreement.
2. Both scores are associated with decision for non-surgical/non-chemotherapy treatment for all stages of disease.
3. Performance scores are useful in routine assessment of patients with suspected lung cancer.

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Citations should be made in the following way:
S. Wyn-Jones, K. Whitfield, G. Antunes, S. Murphy (Middlesbrough, United Kingdom). Performance scores in patients with suspected lung cancer: reliability of scoring and impact on treatment. Eur Respir J 2009; 34: Suppl. 53, 4690

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