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Karnofsky And ECOG Performance Status Scoring In Lung Cancer: A Prospective, Longitudinal Study Of 536 Patients From A Single Institution.
G. Buccheri, D. Ferrigno, M. Tamburini
Published 1996 · Medicine
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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.
This paper references
Performance status assessment in cancer patients. An inter-observer variability study.
J. Sørensen (1993)
The clinical evaluation of chemotherapeutic agents in cancer
Da Karnofsky (1949)
Evaluation of chemotherapeutic agents
C. Macleod (1949)
Anti-CEA immunoscintigraphy might be more useful than computed tomography in the preoperative thoracic evaluation of lung cancer. A comparison between planar immunoscintigraphy, single photon emission computed tomography (SPECT), and computed tomography.
G. Buccheri (1993)
Prognostic factors in lung cancer: tables and comments.
G. Buccheri (1994)
Performance status assessment in cancer patients
C. Conill (1990)
International Histological Classification of Tumours
R. Weller (1981)
A randomised trial of MACC chemotherapy with or without lonidamine in advanced non-small cell lung cancer. Cuneo Lung Cancer Study Group (CuLCaSG)
G. Buccheri (1994)
Clinical value of a multiple biomarker assay in patients with bronchogenic carcinoma
Gian Franco Buccheri (1986)
Cancer : Principles and Practice of Oncology
V. Devita (1982)
Cancer of the Lung
I. Todd (1953)
Quality of life assessment. An independent prognostic variable for survival in lung cancer
P. Ganz (1991)
Manual for Staging of Cancer
O. Beahrs (1992)
Imaging lung cancer by scintigraphy with indium 111‐labeled F(ab')2 fragments of the anticarcinoembryonic antigen monoclonal antibody F023C5
G. Buccheri (1992)
Performance and prognosis in patients with lung cancer. The Edinburgh Lung Cancer Group.
S. Capewell (1990)
Performance status assessment among oncology patients: a review.
S. T. Orr (1986)
Can Karnofsky performance status be transformed to the Eastern Cooperative Oncology Group scoring scale and vice versa?
E. Verger (1992)
Regression Models and Life-Tables
D. Cox (1972)
Appraisal of methods for the study of chemotherapy of cancer in man: Comparative therapeutic trial of nitrogen mustard and triethylene thiophosphoramide
C. Zubrod (1960)
Nonparametric Statistics for the Behavioral Sciences.
F. N. David (1956)
A phase II study of methotrexate, doxorubicin, cyclophosphamide, and lomustine chemotherapy and lonidamine in advanced non‐small cell lung cancer
G. Buccheri (1993)
Symptomatic, stage IV, non-small-cell lung cancer (NSCLC): response, toxicity, performance status change and symptom relief in patients treated with cisplatin, vinblastine and mitomycin-C
D. Tummarello (2004)
The Karnofsky performance status scale: An examination of its reliability and validity in a research setting
V. Mor (1984)
Karnofsky performance status revisited: reliability, validity, and guidelines.
C. A. Schag (1984)
Nonparametric Estimation from Incomplete Observations
E. L. Kaplan (1958)
Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples.
R. Peto (1977)
Reporting results of cancer treatment
A. Miller (1981)
Tumor markers in bronchogenic carcinoma. Superiority of tissue polypeptide antigen to carcinoembryonic antigen and carbohydrate antigenic determinant 19‐9
G. Buccheri (1987)
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R. Salloum (2011)
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G. Bronte (2015)
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A. Martín (2016)
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L. Luo (2015)
Admission factors associated with prolonged (>14 days) intensive care unit stay.
F. Zampieri (2014)
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Chia-Chin Lin (2000)
Therapeutic exercise in cancer cachexia.
M. Maddocks (2012)
Role of Surgery in the Management for Gastric Cancer with Synchronous Distant Metastases
M. Ikeguchi (2015)
The prognostic implications of EGFR mutation and ALK rearrangement for the long‐term outcomes of patients with resected lung adenocarcinomas
H. Kim (2019)
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C. Burtin (2020)
VALORACIÓN Y ANÁLISIS DE LAS ESTRATEGIAS DE AFRONTAMIENTO DE LOS ENFERMOS ONCOLÓGICOS CON DOLOR CRÓNICO
J. San (2014)
The role of cancer rehabilitation in the maintenance of functional integrity and quality of life
A. Cheville (2007)
Quality Indicators for the Care of Breast Cancer in Vulnerable Elders
A. Naeim (2007)
One-year stability of care dependency in patients with advanced chronic organ failure.
D. Janssen (2014)
Assessment of Mobility
Sarah Callin (2009)
The Society of Thoracic Surgeons Lung Cancer Resection Risk Model: Higher Quality Data and Superior Outcomes.
F. Fernandez (2016)
Natural history of untreated head and neck cancer.
L. Kowalski (2000)
Sublingual fentanyl orally disintegrating tablet in daily practice: efficacy, safety and tolerability in patients with breakthrough cancer pain
M. Überall (2011)
A pure microcytic bladder carcinoma synchronous to prostatic adenocarcinoma
Vasileios Sakalis (2011)
Melanoma patients in a phase I clinic: molecular aberrations, targeted therapy and outcomes.
H. Henary (2013)
Immunoablative High-Dose Cyclophosphamide without Stem-Cell Rescue for Refractory, Severe Autoimmune Disease
R. Brodsky (1998)
Performance Status and Smoking Status Are Independent Favorable Prognostic Factors for Survival in Non-small Cell Lung Cancer: A Comprehensive Analysis of 26,957 Patients with NSCLC
T. Kawaguchi (2010)
A scoring system to guide the decision for a new systemic treatment after at least two lines of palliative chemotherapy for metastatic cancers: a prospective study
B. Chanez (2017)
Changes in symptom severity in Taiwanese lung cancer patients after gefitinib treatment: a pilot study.
Shu-yi Wang (2014)
Challenges in defining and identifying patients with non-small cell lung cancer and poor performance status.
K. Kelly (2004)
Prognostic performance of the modified-G8 screening instrument for patients aged 60 years or older: A prospective cohort of 889 Brazilian patients.
Davi Brito Camara (2019)
Patients with advanced non-small-cell lung cancer and marginal performance status: walking the tight rope towards improved survival.
H. West (2013)
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