P2.01-77 Interconversion of Two Commonly Used Performance Tools: An Analysis of 5844 Paired Assessments in 1501 Lung Cancer Patients

Abstract

Karnofsky Performance Status (KPS) scale and Eastern Cooperative Oncology Group (ECOG) scale are the most commonly used performance status (PS) tools worldwide. The current study aimed to assess correlation between KPS and ECOG PS in a large cohort from a lung cancer (LC) clinic database and to determine KPS categories which were most equivalent to ECOG PS scores. All patients attending LC clinic at a tertiary care centre over a 5-year period 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. Different KPS categories equivalent to ECOG PS were compared using hit rate and weighted kappa (κw). A total of 1501 patients were assessed over study period providing 5844 paired KPS and ECOG PS assessments. The cohort had a mean (standard deviation SD) age of 58.4 (10.8) years with majority being current/ex-smokers (76.9%) and males (82.3%). NSCLC was commonest histological type (n=1196, 79.7%) with majority having advanced (stages IIIB/IV) disease (83.4%). Mean baseline KPS and ECOG PS scores were 77.6 (SD=14.4) and 1.5 (SD=1) respectively. 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. The current study provides largest set of paired KPS-ECOG assessments till date. Although both PS tools had good correlation, the performance of the KPS categories previously suggested as being equivalent to ECOG PS categories was found to be highly variable. Cancer clinics should develop and validate their own population-specific KPS categories for interconversion of KPS to ECOG PS.