Karnofsky Performance Scale (KPS) or Physical Performance Test (PPT)? That is the question.

Oncologists usually base treatment decision on the assessment of patients' performance status (PS). This study was undertaken to explore the ability of KPS to correctly assess the PS of elderly cancer patients, comparing it to a validated geriatric tool named Physical Performance Test (PPT). One single examiner assessed elderly cancer patients' PS at registration in our institution and performed the PPT on patients with KPS ≥ 60. A sample of 152 patients actually underwent PPT. A low refusal rate was observed (<5%). Most patients (82%) had a high PS (KPS ≥ 80), whereas only 20% had no health impairment according to PPT scores. Patients' gender and disease stage did not correlate with PPT scores. The KPS seems to be a less accurate tool than the PPT to assess functional status of elderly cancer patients. Then PPT could be used as an inclusion criterion instead of KPS before cancer treatment decision.