Interconversion of two commonly used performance tools: An analysis of 5844 paired assessments in 1501 lung cancer patients

Abstract

AIMTo establish the Karnofsky performance status (KPS) categories which would facilitate the interconversion of the KPS scale to the Eastern Cooperative Oncology Group (ECOG) performance status (PS) scale.METHODSThis was a retrospective analysis of all patients attending the lung cancer clinic at a tertiary care center over a 5-year period (September 2009 to August 2014). All patients were assessed with both KPS and ECOG PS scales at each visit. Correlation between KPS and ECOG PS was assessed using Spearman’s correlation coefficient. KPS categories equivalent to ECOG PS scores were compared using hit rate and weighted kappa (κw).RESULTSA total of 1501 patients were assessed over the study period, providing 5844 paired KPS and ECOG PS assessments. The study cohort had a mean (standard deviation; SD) age of 58.4 (10.8) years, with the majority being current or ex-smokers (76.9%) and males (82.3%). Non-small cell lung cancer was the most common histological type (n = 1196, 79.7%) with the majority having advanced (stage IIIB/IV) disease (83.4%). Mean baseline KPS and ECOG PS scores were 77.6 (SD = 14.4) and 1.5 (SD = 1) respectively. The most frequent KPS score was 80 (29%), and the most frequent ECOG PS score was 1 (43%). The overall correlation between KPS and ECOG PS was good (Spearman r = -0.84, P < 0.0001) but ranged from -0.727 to -0.972 between visits. KPS categories derived from our cohort [10-40 (ECOG 4), 50-60 (ECOG 3), 70 (ECOG 2), 80-90 (ECOG 1), 100 (ECOG 0)] performed better [hit rate 78.1%, κw = 0.749 (0.736-0.762) P < 0.0001] than those suggested in the past literature.CONCLUSIONThe current study provides the largest set of paired KPS-ECOG assessments to date. We suggest that the KPS categories 10-40, 50-60, 70, 80-90, and 100 are equivalent to ECOG PS categories of 4, 3, 2, 1, and 0 respectively.

Programmed death-ligand 1 expression and tumor-infiltrating lymphocytes in non-small cell lung cancer: association with clinicopathologic parameters

“…The study had a relatively small sample size (n = 128). A disproportionately larger proportion of patients had stage IV disease (62.7% with stage IV disease in this study compared with 51.1% with stage IV disease in a previous analysis from our center with a much larger sample size (n = 1,501) [14]. The EGFR and ALK positivity rate observed in this study was considerably lower than what is generally ob- Tumors with PD-L1 expression > 50% on tumor cells (TC2) or PD-L1 expression of 1%-50% on tumor cells (TC1) with PD-L1 expression > 10% in TILs (IC2) were considered PD-L1-positive.…”

UGT1A1 Gene Polymorphisms in Patients with Small Cell Lung Cancer Treated with Irinotecan-Platinum Doublet Chemotherapy and Their Association with Gastrointestinal Toxicity and Overall Survival

“…However, as compared with the general lung cancer population at our center of which SCLC comprises around 20% of all cases, the current study cohort being limited to only patients with SCLC, was dominated by current/ex-smokers and by moderate/heavy smokers (SI > 100). Also, patients with ECOG PS ≥2 (typically excluded from randomized trials) constituted a substantial percentage of our cohort (in line with what is typically seen in our clinic in a real-world setting) [17].…”

“…It is worthwhile to mention here that the demographic profile of patients with SCLC in this study (including mean dominated by current/ex-smokers and by moderate/heavy smokers (SI > 100). Also, patients with ECOG PS ≥2 (typically excluded from randomized trials) constituted a substantial percentage of our cohort (in line with what is typically seen in our clinic in a real-world setting) [17].…”

Enteral Nutrition Combined with Improved-Sijunzi Decoction Shows Positive Effect in Precachexia Cancer Patients: A Retrospective Analysis

“…As a predicted survival in patients with cancer, the performance status (PS) had the ability to measure the activities of daily living. It is well known that patients with poor performance status always avoid more aggressive treatment [39][40][41]. e KPS score and ECOG score are the most commonly used for the assessment of PS.…”