Background Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores are used to quantify overall disease status and are widely used to stratify participants at clinical trial entry. Longitudinal ECOG-PS measurement between 2 tumor types may provide important data for patient management in community settings.
Objective To describe oncology patients’ performance status before and after their first course of chemotherapy.
Methods ECOG-PS scores from electronic medical records (EMRs) of 47 oncology clinics across the United States were retrieved. The included patients had breast, lymphoma, prostate, colorectal, or lung cancers and ECOG-PS scores within ± 14 days of initiation and completion of the first chemotherapy course. Descriptive statistics of ECOG-PS were analyzed and compared within tumor types (via the Wilcoxon signed-rank test) and between tumor types (via the Kruskal-Wallis test).
Results In all, 7,912 cancer patients were identified as having breast cancer, lymphoma, prostate cancer, colorectal cancer, or lung cancer. At baseline, patients’ mean (SD) ECOG-PS scores were breast cancer, 0.51 (0.01); lymphoma, 0.82 (0.02); prostate cancer, 1.04 (0.05); colorectal cancer, 0.72 (0.02); and lung cancer, 0.97 (0.02). The percentages of patients with ECOG-PS < 2 at chemotherapy start were 94%, 86%, 78%, 89%, and 81% for each tumor, respectively; percentages at the end of the first course were 88%, 80%, 68%, 84%, and 66%, respectively. All pre- and postchemotherapy comparisons of scores between tumor types were statistically significantly different (P < .001), with the exceptions of lung and prostate cancer before chemotherapy, and lung, prostate, lymphoma, and colorectal cancers after chemotherapy. Changes of ECOG-PS scores from baseline to postchemotherapy assessments were statistically significant in all tumor types (P < .01).
Limitations The lack of a standardized method for collecting ECOG-PS scores in routine oncology practice led to the unavailability of scores for many patients.
Conclusions This study describes a national sample of community oncology patients’ performance status. Even though there was a significant drop in ECOG-PS scores from pre- to postchemotherapy, good ECOG-PS scores were maintained in a majority of patients. These findings demonstrate that ECOG-PS scores can be routinely assessed and can aid in decisions throughout chemo- therapy and in the planning for future treatments.
Funding Amgen Inc funded the study.
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