Prasad Kuruswamy Thurai, Kaur Harpreet, Muthu Valliappan, Aggarwal Ashutosh Nath, Behera Digambar, Singh Navneet
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.
World J Clin Oncol. 2018 Nov 10;9(7):140-147. doi: 10.5306/wjco.v9.i7.140.
To 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.
This 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 (κ).
A 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 ( = 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 = -0.84, < 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%, κ = 0.749 (0.736-0.762) < 0.0001] than those suggested in the past literature.
The 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.
建立卡氏功能状态（KPS）分类，以促进KPS量表与东部肿瘤协作组（ECOG）功能状态（PS）量表之间的相互转换。
这是一项对一家三级医疗中心肺癌门诊5年期间（2009年9月至2014年8月）所有患者的回顾性分析。所有患者每次就诊时均使用KPS和ECOG PS量表进行评估。使用Spearman相关系数评估KPS和ECOG PS之间的相关性。使用命中率和加权kappa（κ）比较与ECOG PS评分等效的KPS类别。
在研究期间共评估了1501例患者，提供了5844对KPS和ECOG PS评估。研究队列的平均（标准差；SD）年龄为58.4（10.8）岁，大多数为当前或既往吸烟者（76.9%）和男性（82.3%）。非小细胞肺癌是最常见的组织学类型（n = 1196，79.7%），大多数患有晚期（IIIB/IV期）疾病（83.4%）。平均基线KPS和ECOG PS评分分别为77.6（SD = 14.4）和1.5（SD = 1）。最常见的KPS评分为80（29%），最常见的ECOG PS评分为1（43%）。KPS和ECOG PS之间的总体相关性良好（Spearman ρ = -0.84，P < 0.0001），但就诊之间的范围为-0.727至-0.972。从我们的队列中得出的KPS类别[10 - 40（ECOG 4），50 - 60（ECOG 3），70（ECOG 2），80 - 90（ECOG 1），100（ECOG 0）]的表现优于过去文献中建议的类别[命中率78.1%，κ = 0.749（0.736 - 0.762），P < 0.0001]。
本研究提供了迄今为止最大的一组配对KPS - ECOG评估。我们建议KPS类别10 - 40、50 - 60、70、80 - 90和100分别等同于ECOG PS类别4、3、2、1和0。
