Assessment of physical functioning in surgical candidates with non-small cell lung cancer: Preliminary comparison of performance status to symptom-limited cardiopulmonary exercise testing

Background: Performance status (PS) scoring systems are used routinely by clinicians to guide management of patients with non-small cell lung cancer (NSCLC). However, PS scoring systems are subjective with poor inter-rater reliability and do not provide an objective measure of functional status. The aim of this study was to compare the variability in an objective measure of cardiorespiratory fitness (VO 2peak ), among surgical candidates with histologically confirmed NSCLC across different PS categories as assessed by the Eastern Cooperative Oncology Group (ECOG) score. Methods: Using a cross-sectional design, 389 subjects underwent an incremental cardiopulmonary exercise test with expired gas analysis to determine VO 2peak prior to surgical resection. Results: Mean VO 2peak significantly declined across increasing ECOG categories (Table 1). There was a wide range in VO 2peak in each ECOG category with similar ranges in VO 2peak within groups, in particular in subjects classified as ECOG 1 and 2. Conclusions: VO 2peak may provide a more sensitive evaluation of physical functioning than ECOG. Accurate assessment of functional status may have important implications for mortality risk and therapeutic management in the oncology setting.