title: Survival Prediction in Ambulatory Patients With Stage III/IV Non-Small Cell Lung Cancer Using the Palliative Performance Scale, ECOG, and Lung Cancer Symptom Scale.
abstract: OBJECTIVE
  Patients with advanced non-small cell lung cancer (NSCLC) have a life expectancy of less than 1 year. Therefore, it is important to maximize their quality of life and find a tool that can more accurately predict survival.
  
  
  METHODS
  The Palliative Performance Scale (PPS) is used to predict survival for patients with advanced disease based on functional dimensions. The value of the PPS in ambulatory patients with cancer has not been examined to date. The Lung Cancer Symptom Scale (LCSS) measures six major symptoms and their effect on symptomatic distress and activity. We evaluated 62 patients with stage III or IV NSCLC and Eastern Cooperative Oncology Group (ECOG) Scale Score ≥1 at baseline in a thoracic oncology clinic. In all, 62 patients had LCSS and PPS evaluated at baseline and 54 patients had 4-week follow-up using LCSS, PPS, and ECOG.
  
  
  RESULTS
  Fifty-four patients completed baseline and follow-up. Mean age was 63.7 years. Sixty-three percent were receiving chemotherapy at evaluation. Seventeen patients died. Mean baseline measures were LCSS 6.18 (1-14); PPS 66.6 (40-90); and ECOG 1.82 (1-4). Censored survival times were calculated from enrollment of the first patient for 380 days. A proportional hazardous model was computed for survival status. Hazard ratios for death were 1.25 (P = .013) for LCSS, 2.12 (P = .027) for ECOG, and 1.02 for PPS (P = .49).
  
  
  CONCLUSIONS
  The LCSS predicted prognosis best in this study. The PPS did not accurately predict prognosis in our patient population.
authors: Section of Palliative Medicine, Section of Medical Oncology, Rush University Medical Center, Chicago, IL, USA.
authors: Sean
authors: S
authors: O'Mahony
authors: Section of Palliative Medicine, Section of Medical Oncology, Rush University Medical Center, Chicago, IL, USA Susan_nathan@rush.edu.
authors: Susan
authors: S
authors: Nathan
authors: Division of Hematology and Oncology, John H. Stroger Hospital of Cook County, Chicago, IL, USA.
authors: Roozbeh
authors: R
authors: Mohajer
authors: Section of Palliative Medicine, Section of Medical Oncology, Rush University Medical Center, Chicago, IL, USA.
authors: Philip
authors: P
authors: Bonomi
authors: Section of Palliative Medicine, Section of Medical Oncology, Rush University Medical Center, Chicago, IL, USA.
authors: Marta
authors: M
authors: Batus
authors: Section of Palliative Medicine, Section of Medical Oncology, Rush University Medical Center, Chicago, IL, USA.
authors: Mary Jo
authors: MJ
authors: Fidler
authors: Section of Palliative Medicine, Section of Medical Oncology, Rush University Medical Center, Chicago, IL, USA.
authors: Kalani
authors: K
authors: Wells
authors: Northwestern Memorial Hospital, Chicago, IL, USA.
authors: Naomi
authors: N
authors: Kern
authors: Section of Palliative Medicine, Section of Medical Oncology, Rush University Medical Center, Chicago, IL, USA.
authors: Shannon
authors: S
authors: Sims
authors: Section of Palliative Medicine, Section of Medical Oncology, Rush University Medical Center, Chicago, IL, USA.
authors: Darpan
authors: D
authors: Amin
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality*; D004032:Diet; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D011788:Quality of Life
keywords: ECOG; lung cancer; lung cancer symptom scale; palliative care; palliative performance scale; prognostication