Abstract 1880P
Background
Performance status (PS) is a strong, validated prognostic factor across all cancer types, especially in the advanced phase. It is estimated usually by the Karnofsky (KPS) or the ECOG scale, each of them having peculiar features. Two possible way of comparing KPS and ECOG scales are possibile, differing in the attribution of KPS 90,70, 50 and 30% respectively to PS 0,1,2 and 3 or to 1,2,3 and 4. From the limited data available, the latter comparison seems to better adapt to real-world clinical data (Verger E, Cancer 1992).
Methods
From 1st May 2019 to 19th May 2020 all the consecutive values of KPS and ECOG PS were simultaneously recorded from every clinical evaulation of three medical oncologists from the Lung Cancer Unit. In particular, KPS values were estimated with the help of specific questions involving the domain of daily self-dependence and self-care (Schag CC, JCO 1984). The attribution of KPS 90,70,50 and 30% to PS 0,1,2 and 3 or to PS 1,2,3 and 4 was defined respectively as the BOLD or the CONSERVATIVE comparison. Moreover, data about DISCORDANT cases (i.e. very different KPS and ECOG values) were analyzed.
Results
Values of KPS and ECOG PS from two-thousand consecutive clinical evaluations were collected, 86.5% conducted in an outpatient setting and 78.3% in patients affected by NSCLC or SCLC. Median age of patients was 68.2 years, male/female ratio was 2.26. Mean values of KPS and ECOG PS for the entire cohort were 79.98% and 1.1. The distribution of the attribution of KPS 90,70,50 and 30% to the BOLD or to the CONSERVATIVE comparison was: Table: 1880P
| BOLD | KPS (n.) | CONSERVATIVE |
| PS 0: 53.3% (309) | 90% (579) | PS 1: 46.7% (270) |
| PS 1: 9,8% (35) | 70% (357) | PS 2: 90,2% (322) |
| PS 2: 2,9% (3) | 50% (102) | PS 3: 97,1% (99) |
| PS 3: 0% (0) | 30% (8) | PS 4: 100% (8) |
Discordant KPS-ECOG values were identified in 16 cases (0.8%): 14 with KPS 60%-PS 3 (all cases with advanced thoracic cancers), 1 with 50%-PS 2, and 1 with 80%-PS 0.
Conclusions
In a real-practice population of aggressive cancers the CONSERVATIVE way of comparing ECOG PS and KPS seems to fit better the clinical data, especially when PS worsens (KPS 70, 50 or 30%). Further researches are however needed to improve the correlation of the two PS scales.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.