Eastern Cooperative Oncology Group (ECOG) Performance Status

ECOG Performance Status

Score:–

–

Determines ability of patient to tolerate therapies in serious illness, specifically for chemotherapy, simpler than the Karnofsky Scale .

Why Use

Performance status is highly correlated with survival, need for services, and may help predict ability to tolerate therapies.

When to Use

Patients with active cancer under treatment.

Formula

Criteria Score Description Asymptomatic 0 Fully active, able to carry on all predisease activities without restriction. Symptomatic but completely ambulatory 1 Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature. For example, light housework, office work. Symptomatic, <50% in bed during the day 2 Ambulatory and capable of all self care but unable to carry out any work activities. Up and about more than 50% of waking hours. Symptomatic, >50% in bed, but not bedbound 3 Capable of only limited self-care, confined to bed or chair 50% or more of waking hours. Bedbound 4 Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair. Death 5

Pearls / Pitfalls

The ECOG Performance Status is a simple measure of functional status. It has scores ranging from 0 to 5, and these correlate with scores from the Karnofsky Scale ’s 0-100 scores. It is commonly used as a prognostic tool, as a selection criterion for cancer research, and to help determine treatment.

Management

We are unaware of validated management algorithms using the ECOG Performance Status.

Critical Actions

The ECOG Performance Status and other performance scales should be used in the holistic assessment of cancer patients, though their accuracy as prognostic tools in individual cases is not yet proved.

Advice

The ECOG Performance Status may be slightly better than Karnofsky for discriminating prognostically and, as an adaptation of Karnofsky , is likely to be at least similar in other domains. It is also simpler to use, and therefore may be preferred.

More Information

Karnofsky vs. ECOG ECOG PERFORMANCE STATUS KARNOFSKY PERFORMANCE STATUS 0—Fully active, able to carry on all pre-disease performance without restriction 100—Normal, no complaints; no evidence of disease 90—Able to carry on normal activity; minor signs or symptoms of disease 1—Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work 80—Normal activity with effort, some signs or symptoms of disease 70—Cares for self but unable to carry on normal activity or to do active work 2—Ambulatory and capable of all selfcare but unable to carry out any work activities; up and about more than 50% of waking hours 60—Requires occasional assistance but is able to care for most of personal needs 50—Requires considerable assistance and frequent medical care 3—Capable of only limited selfcare; confined to bed or chair more than 50% of waking hours 40—Disabled; requires special care and assistance 30—Severely disabled; hospitalization is indicated although death not imminent 4—Completely disabled; cannot carry on any selfcare; totally confined to bed or chair 20—Very ill; hospitalization and active supportive care necessary 10—Moribund 5—Dead 0—Dead