Predictive survival ability of patient-reported in comparison to physician-reported performance status in solid malignancies.

Abstract

7019 Background: Performance status (PS) is an important prognostic tool in cancer management that is mainly generated by physicians. In oncology, the Eastern Cooperative Oncology Group (ECOG) measure is commonly used. Patient-reported functional status (PRFS) is an emerging method that allows patients to provide an estimate of their function; however, there is limited information about its prognostic significance in solid tumors. We explored the prognostic value of PRFS in comparison to ECOG on survival. Methods: 13,045 newly diagnosed cancer patients in Ontario, Canada, who had information from both PRFS and ECOG on the same day of an outpatient visit between March 2013 and March 2018 were included. The dataset were randomly divided into 60% training (n = 7,827) and 40% validation (n = 5,218) cohorts. Covariates were similar at baseline for both training and validation datasets. Survival was estimated by modeling clinical characteristics with PRFS, with ECOG, and alone. Results: PRFS and ECOG scores were statistically significant predictors of overall survival. Both higher PRFS and ECOG scores tended to be associated with inferior survival, hazard ratio (HR) = 1.71 (P < .0001), and HR = 1.90 (P < .0001) respectively. Models that included either PRFS or ECOG scores outperformed the model with baseline clinical characteristics only. C statistics were 0.836, 0.839, and 0.811 respectively. Conclusions: Patient-reported functional status adds to survival modeling and is equally predictive as the ECOG scale at various stages of solid malignancies. PRFS may be used instead of ECOG in clinical or research setting for survival estimation.