Buccheri G, Ferrigno D, Tamburini M
Lung Cancer Unit, A. Carle Hospital, Cuneo, Italy.
Eur J Cancer. 1996 Jun;32A(7):1135-41. doi: 10.1016/0959-8049(95)00664-8.
The Karnofsky's index of performance status (KPS) and the Eastern Cooperative Oncology Group Performance Status Scale (ECOG PS) are widely used methods of assessing the functional status of cancer patients. In this study, we compare their predictive validity, and suggest a table of transformation between scales. 536 consecutive lung cancer patients were assigned both KPS and ECOG PS scores before, during and after treatment (in all, 1656 assignments). Patients were accurately staged at diagnosis, and carefully re-evaluated at each follow-up visit. Multiple clinical, laboratory and instrumental data were recorded along with performance status assessments. Survival times were measured from the pathological diagnosis. KPS and ECOG PS assignments were strongly related to each other (Spearman R = -0.869). Correlation between scales persisted unchanged in pretreatment and post-treatment assessments, advanced and limited diseases, response or non-response to treatment, and different assessors (R indices ranging from -0.825 to -0.901). A three-point conversion table showed the highest rate of success with an overall percentage of agreement exceeding 84% (grade 1: KPS = 100, 90, 80 and ECOG PS = 0, 1; grade 2: KPS = 70, 60 and ECOG PS = 2; grade 3: KPS < 60 and ECOG PS = 3, 4). Both univariate and multivariate analyses of survival documented the predictive validity of the two scales. However, KPS showed less ability than ECOG PS to discriminate patients with different prognosis. Because of the better predictive ability shown in this study, ECOG PS should be preferred to KPS. A general consensus on the scale to use could avoid problems of conversion, which is not always easy and free of errors.
卡诺夫斯基性能状态指数（KPS）和东部肿瘤协作组性能状态量表（ECOG PS）是评估癌症患者功能状态的广泛使用的方法。在本研究中，我们比较了它们的预测效度，并提出了量表之间的转换表。536例连续肺癌患者在治疗前、治疗期间和治疗后均被赋予KPS和ECOG PS评分（总共1656次评分）。患者在诊断时被准确分期，并在每次随访时进行仔细重新评估。记录了多项临床、实验室和仪器数据以及性能状态评估。生存时间从病理诊断开始测量。KPS和ECOG PS评分彼此密切相关（斯皮尔曼R=-0.869）。在治疗前和治疗后评估、晚期和局限性疾病、对治疗的反应或无反应以及不同评估者之间，量表之间的相关性保持不变（R指数范围为-0.825至-0.901）。一个三分制转换表显示成功率最高，总体一致率超过84%（1级：KPS=100、90、80，ECOG PS=0、1；2级：KPS=70、60，ECOG PS=2；3级：KPS<60，ECOG PS=3、4）。生存的单变量和多变量分析都证明了这两个量表的预测效度。然而，KPS在区分不同预后患者方面的能力不如ECOG PS。由于本研究显示出更好的预测能力，ECOG PS应优先于KPS。就使用的量表达成普遍共识可以避免转换问题，转换并不总是容易且无误的。
