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Ashutosh Nath Aggarwal



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    P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.01-77 - Interconversion of Two Commonly Used Performance Tools: An Analysis of 5844 Paired Assessments in 1501 Lung Cancer Patients (ID 12723)

      16:45 - 18:00  |  Author(s): Ashutosh Nath Aggarwal

      • Abstract
      • Slides

      Background

      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.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      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).

      4c3880bb027f159e801041b1021e88e8 Result

      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.

      Table: Comparison of various suggested KPS categories for KPS-ECOG PS interconversion in the current cohort
      Author, Year N (Patients [assessments]) Suggested KPS Categories Hit rate κw (95% confidence interval)
      AJCC, 1977 - 10-20, 30-40, 50-60, 70-80, 90-100 43.6% 0.376 (0.363-0.389) P<0.0001
      Minna, 1985 - 20-30, 40-50, 60-70, 80-90, 100 75.2% 0.701 (0.687-0.714) P<0.0001
      Buccheri, 1996 536 [1656] 10-50, 60-70, 80-100

      83.2%

      		 0.695 (0.679-0.711) P<0.0001
      Ma, 2010 1385 (1385) 10-30, 40-50, 60-70, 80-90, 100 75.2% 0.701 (0.687-0.714) P<0.0001
      de Kock, 2013 955 (674) 10-20, 30-40, 50, 60-100 43.2% 0.079 (0.068-0.090) P<0.0001
      Current study 1501 (5844) 10-40, 50-60, 70, 80-90, 100 78.1% 0.749 (0.736-0.762) P<0.0001
      8eea62084ca7e541d918e823422bd82e Conclusion

      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.

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