Translation of Karnofsky Performance Status ( KPS ) for Use in Inpatient Cancer Rehabilitation

PM&R ◽  
2021 ◽  
Author(s):  
Keara M. McNair ◽  
Dana Zeitlin ◽  
Anna Marie Slivka ◽  
Anthony H. Lequerica ◽  
Michael D. Stubblefield
Keyword(s):  
Karnofsky Performance Status ◽  
Performance Status ◽  
Cancer Rehabilitation

scholarly journals Predictors of Survival in Subtotally Resected WHO Grade I Skull Base Meningiomas

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1451
Author(s):  
Michele Da Broi ◽  
Paola Borrelli ◽  
Torstein R. Meling
Keyword(s):  
Skull Base ◽  
Clinical Outcomes ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Multivariable Analysis ◽  
Advanced Age ◽  
Final Visit ◽  
Subtotal Resection ◽  
Who Grade ◽  
Skull Base Meningiomas

Background: Although gross total resection (GTR) is the goal in meningioma surgery, this can sometimes be difficult to achieve in skull base meningiomas. We analyzed clinical outcomes and predictors of survival for subtotally resected benign meningiomas. Methods: A total of 212 consecutive patients who underwent subtotal resection (STR) for benign skull base meningioma between 1990–2010 were investigated. Results: Median age was 57.7 [IQR 18.8] years, median preoperative Karnofsky performance status (KPS) was 80.0 [IQR 20.0], 75 patients (35.4%) had posterior fossa meningioma. After a median follow-up of 6.2 [IQR 7.9] years, retreatment (either radiotherapy or repeated surgery) rate was 16% at 1-year, 27% at 3-years, 34% at 5-years, and 38% at 10-years. Ten patients (4.7%) died perioperatively, 9 (3.5%) had postoperative hematomas, and 2 (0.8%) had postoperative infections. Neurological outcome at final visit was improved/stable in 122 patients (70%). Multivariable analysis identified advanced age and preoperative KPS < 70 as negative predictors for overall survival (OS). Patients who underwent retreatment had no significant reduction of OS. Conclusions: Advanced age and preoperative KPS were independent predictors of OS. Retreatments did not prolong nor shorten the OS. Clinical outcomes in STR skull base meningiomas were generally worse compared to cohorts with high rates of GTR.

scholarly journals QOLP-26. USE OF MEDICAL ASSISTANCE IN DYING (“DEATH WITH DIGNITY”) IN WASHINGTON STATE PATIENTS WITH BRAIN TUMORS.

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii180-ii180
Author(s):  
Jerome Graber ◽  
Kaite Sofie ◽  
Lynne Taylor
Keyword(s):  
Brain Tumors ◽  
Terminal Illness ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
High Grade Glioma ◽  
Washington State ◽  
Medical Assistance ◽  
Death With Dignity ◽  
Medical Assistance In Dying ◽  
Diagnosis Of Cancer

Abstract Since 2009, Washington State has had a “Death with Dignity” (DWD) process whereby people with a terminal illness may legally obtain a prescription for medications that will end their life. Patients initiate a voluntary request from two physicians certifying they have a prognosis &lt; 6 months, are aware of other palliative care options, and have capacity without the comorbidity of a psychiatric diagnosis. Since 2015, over 200 people annually have used the DWD process in Washington. Other papers have described the characteristics of people using DWD with a diagnosis of cancer or amyotrophic lateral sclerosis (ALS) but none have specifically looked at patients with brain tumors (BT) who used DWD. We describe 20 people with BT who accessed DWD since 2015 at our center. Median age at the time of death was 51 (range 38-79) and 75% were men. Glioblastoma was the diagnosis in 10 (50%), anaplastic glioma in 8 (40%), grade II astrocytoma in 1, and a presumed high-grade glioma by imaging in 1. Median Karnofsky Performance Status (KPS) was 90 at diagnosis (range 50-100) and 70 at DWD request (range 40-90). Standard radiation (RT) and chemotherapy was used by 17 (85%) prior to DWD request, while 3 patients (15%, ages 70-79, KPS 50-90) requested DWD immediately after diagnosis and did not undergo further treatment. Pain was present in 4 patients (20%), 2 using opioids (10%). Six patients (30%) continued tumor treatments after approval for DWD. Median OS was 22 months (range 2-285) and 24 months excluding patients who declined treatment (range 8-285). Most glioma patients in our cohort requested DWD after undergoing chemoradiation, pain was uncommon and rarely severe, and survival from diagnosis was comparable to standard therapy. As access to medical assistance in dying continues, further research is needed on its utilization for people with brain tumors.

scholarly journals Cyberknife® hypofractionated stereotactic radiosurgery (CK-hSRS) as salvage treatment for brain metastases

2021 ◽  
Author(s):  
Sergej Telentschak ◽  
Daniel Ruess ◽  
Stefan Grau ◽  
Roland Goldbrunner ◽  
Niklas von Spreckelsen ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Poor Prognosis ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Salvage Treatment ◽  
Treatment Modalities ◽  
Large Tumor ◽  
Fractionated Radiotherapy ◽  
Hypofractionated Stereotactic Radiosurgery

Abstract Purpose The introduction of hypofractionated stereotactic radiosurgery (hSRS) extended the treatment modalities beyond the well-established single-fraction stereotactic radiosurgery and fractionated radiotherapy. Here, we report the efficacy and side effects of hSRS using Cyberknife® (CK-hSRS) for the treatment of patients with critical brain metastases (BM) and a very poor prognosis. We discuss our experience in light of current literature. Methods All patients who underwent CK-hSRS over 3 years were retrospectively included. We applied a surface dose of 27 Gy in 3 fractions. Rates of local control (LC), systemic progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan–Meier method. Treatment-related complications were rated using the Common Terminology Criteria for Adverse Events (CTCAE). Results We analyzed 34 patients with 75 BM. 53% of the patients had a large tumor, tumor location was eloquent in 32%, and deep seated in 15%. 36% of tumors were recurrent after previous irradiation. The median Karnofsky Performance Status was 65%. The actuarial rates of LC at 3, 6, and 12 months were 98%, 98%, and 78.6%, respectively. Three, 6, and 12 months PFS was 38%, 32%, and 15%, and OS was 65%, 47%, and 28%, respectively. Median OS was significantly associated with higher KPS, which was the only significant factor for survival. Complications CTCAE grade 1–3 were observed in 12%. Conclusion Our radiation schedule showed a reasonable treatment effectiveness and tolerance. Representing an optimal salvage treatment for critical BM in patients with a very poor prognosis and clinical performance state, CK-hSRS may close the gap between surgery, stereotactic radiosurgery, conventional radiotherapy, and palliative care.

Surgical Indication Optimization of Brain Metastases Based on the Evolutionary Analysis of Karnofsky Performance Status

2021 ◽  
Author(s):  
Jorge Rasmussen ◽  
Pablo Ajler ◽  
Daniela Massa ◽  
Pedro Plou ◽  
Matteo Baccanelli ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Functional Status ◽  
Surgical Resection ◽  
Pharmacological Treatment ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Cohort Analysis ◽  
Surgical Indication ◽  
Evolutionary Analysis ◽  
Survival Curves

Abstract Background and Objective Surgical resection of brain metastases (BM) offers the highest rates of local control and survival; however, it is reserved for patients with good functional status. In particular, the presence of BM tends to oversize the detriment of the overall functional status, causing neurologic deterioration, potentially reversible following symptomatic pharmacological treatment. Thus, a timely indication of surgical resection may be dismissed. We propose to identify and quantify these variations in the functional status of patients with symptomatic BM to optimize the indication of surgical resection. Patients and Methods Historic, retrospective cohort analysis of adult patients undergoing BM microsurgical resection, consecutively from January 2012 to May 2016, was conducted. The Karnofsky performance status (KPS) variation was recorded according to the symptomatic evolution of each patient at specific moments of the diagnostic–therapeutic algorithm. Finally, survival curves were delineated for the main identified factors. Results One hundred and nineteen resection surgeries were performed. The median overall survival was 243 days, while on average it was 305.7 (95% confidence interval [CI]: 250.6–360.9) days. The indication of surgical resection of 10% of the symptomatic patients in our series (7.5% of overall) could have been initially rejected due to pharmacologically reversible neurologic impairment. Survival curves showed statistically significant differences when KPS was stratified following pharmacological symptomatic treatment (p < 0.0001), unlike when they were estimated at the time of BM diagnosis (p = 0.1128). Conclusion The preoperative determination of the functional status by KPS as an evolutive parameter after the nononcologic symptomatic pharmacological treatment allowed us to optimize the surgical indication of patients with symptomatic BM.

scholarly journals Palliative Care and COVID-19 Pandemic: Retrospective Study of Factors Associated With Infection and Death at an Oncological Palliative Care Reference Center

2021 ◽  
pp. 104990912098696
Author(s):  
Livia Costa de Oliveira ◽  
Karla Santos da Costa Rosa ◽  
Ana Luísa Durante ◽  
Luciana de Oliveira Ramadas Rodrigues ◽  
Daianny Arrais de Oliveira da Cunha ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Tumor Type ◽  
Advanced Cancer Patients ◽  
Factors Associated ◽  
Reactive Protein

Background: Advanced cancer patients are part of a group likely to be more susceptible to COVID-19. Aims: To describe the profile of advanced cancer inpatients to an exclusive Palliative Care Unit (PCU) with the diagnosis of COVID-19, and to evaluate the factors associated with death in these cases. Design: Retrospective cohort study with data from advanced cancer inpatients to an exclusive PCU, from March to July 2020, with severe acute respiratory syndrome. Diagnostic of COVID-19 and death were the dependent variables. Logistic regression analyses were performed, with the odds ratio (OR) and 95% confidence interval (CI). Results: One hundred fifty-five patients were selected. The mean age was 60.9 (±13.4) years old and the most prevalent tumor type was breast (30.3%). Eighty-three (53.5%) patients had a diagnostic confirmation of COVID-19. Having diabetes mellitus (OR: 2.2; 95% CI: 1.1-6.6) and having received chemotherapy in less than 30 days before admission (OR: 3.8; 95% CI: 1.2-12.2) were associated factors to diagnosis of COVID-19. Among those infected, 81.9% died and, patients with Karnofsky Performance Status (KPS) < 30% (OR: 14.8; 95% CI 2.7-21.6) and C-reactive protein (CRP) >21.6mg/L (OR: 9.3; 95% CI 1.1-27.8), had a greater chance of achieving this outcome. Conclusion: Advanced cancer patients who underwent chemotherapy in less than 30 days before admission and who had diabetes mellitus were more likely to develop Coronavirus 2019 disease. Among the confirmed cases, those hospitalized with worse KPS and bigger CRP were more likely to die.

scholarly journals NCOG-76. BASELINE COGNITIVE ASSESSMENT IN GLIOMA PATIENTS WITH MGMT PROMOTOR METHYLATION AND/OR 1p19q CODELETION

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii146-ii146
Author(s):  
Sydney Park ◽  
Abigail Giles ◽  
Grace Liberatore ◽  
Katherine Morgan ◽  
Cynthia DeBruhl ◽  
...  
Keyword(s):  
Executive Functioning ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Neuropsychological Testing ◽  
Methylation Status ◽  
Cognitive Status ◽  
Term Survival ◽  
1P19q Codeletion ◽  
Karnofsky Performance Status Score ◽  
Chemotherapy Administration

Abstract INTRODUCTION Methylguanine methyltransferase (MGMT) methylation status is associated with better overall survival while 1p19q co-deletion is associated with long-term survival. Cognitive dysfunction is a common complication of brain tumors and treatment; however, information regarding the relationship between MGMT status, 1p19q codeletion, and cognition is limited. METHOD Baseline neuropsychological testing was performed in patients with malignant glioma prior to radiation and/or chemotherapy administration. A retrospective data analysis was conducted. We calculated composite and subdomain scores for attention/executive functioning, memory, and language in patients with or without MGMT promotor methylation and/or 1p19q codeletion. RESULTS Thirty-eight patients (Age M = 48.73 ± 14.98; 50% female) diagnosed with glioma (29% grade II, 16% grade III, 21% grade IV; Karnofsky Performance Status score (KPS) M = 88.75 ± 14.24) were selected from a retrospective. Memory was marginally significant, such that methylated participants performed better on memory tasks than the unmethylated group (p = .053). Independent samples t-test revealed no significant differences between either marker across the overall cognitive composite (methylated M = 41.35; unmethylated: M = 39.91; p = .955; 1p19q co-deleted: M = 50.94; 1p19q intact: M = 43.66; p = .158) and subdomains attention/executive functioning (p = .585; p = .157) and language (p = .581; p = .765). Logistic regression showed MGMT does not predict cognitive status (p =.052) and there were not enough cases to complete the model with 1p19q. CONCLUSION MGMT status may be correlated with baseline cognitive status as MGMT methylated patients had better memory scores than their unmethylated counterparts. We did not find any significant association between the remaining cognitive domains and MGMT or 1p19q although sample size is a significant limitation. These results suggest further assessment of changes in cognition during treatment through serial neuropsychological testing of glioma populations with defined marker status is warranted.

scholarly journals Glioblastoma Multiforme: an Advanced Analysis of 153 Patients and Review of the Literature

2017 ◽  
Vol 36 (02) ◽  
pp. 080-090 ◽  
Author(s):  
Mohammad Nikdad ◽  
Farshid Farhan ◽  
Milad Shafizadeh ◽  
Atefeh Mirmohseni ◽  
Mohsen Afarideh ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Local Recurrence ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Tertiary Care ◽  
Cox Proportional Hazards ◽  
Recurrence Rates ◽  
Operative Method ◽  
Factors Associated ◽  
Advanced Analysis

Objective Glioblastoma multiforme (GBM) is an aggressive primary tumor with frequent recurrences that leaves patients with a short survival time and a low quality of life. The aim of this study was to review the prognostic factors in patients with glioblastoma multiforme. Material and Methods The focus of this retrospective study was a group of 153 patients with supratentorial GBM tumors, who were admitted to a tertiary-care referral academic center from 2005 to 2013. The factors associated with survival and local recurrence were assessed using the hazard ratio (HR) function of Cox proportional hazards regression and neural network analysis. Results Out of the 153 patients, 99 (64.7%) were male. The average age of the patients was 55.69 ± 15.10 years. The median overall survival (OS) and progression-free survival (PFS) rates were 14.0 and 7.10 months respectively. In the multivariate analysis, age (HR = 2.939, p < 0.001), operative method (HR = 7.416, p < 0.001), temozolomide (TMZ, HR = 11.723, p < 0.001), lomustine (CCNU, HR = 8.139, p < 0.001), occipital lobe involvement (HR = 3.088, p < 0.001) and Karnofsky Performance Status (KPS, HR = 4.831, p < 0.001) scores were shown to be significantly associated with a higher OS rate. Furthermore, higher KPS (HR = 7.292, p < 0.001) readings, the operative method (HR = 0.493, p = 0.005), the use of CCNU (HR = 2.047, p = 0.003) and resection versus chemotherapy (HR = 0.171, p < 0.001) were the significant factors associated with the local recurrence of the tumor. Conclusion Our findings suggest that the use of CCNU and TMZ, the operative method and higher KPS readings are associated with both higher survival and lower local recurrence rates.

scholarly journals Validity of the Karnofsky Performance Status in an HIV-Infected Sample

1995 ◽  
Vol 10 (3) ◽  
pp. 350???357
Author(s):  
Michael W. O??Dell ◽  
Deborah P. Lubeck ◽  
Peter O??Driscoll ◽  
Suzie Matsuno
Keyword(s):  
Karnofsky Performance Status ◽  
Performance Status ◽  
Infected Sample
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