Eastern Cooperative Oncology Group (ECOG) Performance Status
Patients with active cancer under treatment.
- 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.
Performance status is highly correlated with survival, need for services, and may help predict ability to tolerate therapies.
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We are unaware of validated management algorithms using the ECOG Performance Status.
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.
|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.|
Facts & Figures
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|
Original/Primary ReferenceOken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am. J. Clin. Oncol. 1982; 5 (6): 649–55. doi:10.1097/00000421-198212000-00014.PMID 7165009.
About the Creator
Martin M. Oken, MD, is a professor of medicine at the University of Minnesota and the Medical Director of Research at the Hubert H. Humphrey Cancer Center. He was formerly a chairman of the Hematology, Myeloma and Lymphoma Committees of the Eastern Cooperative Oncology Group and Member of the steering Committee for the PLCO (Prostate, Lung, Colon and Ovary Screening Project). His research focuses mainly on treatment and outcomes in patients with leukemia and lymphoma.
To view Dr. Martin Oken's publications, visit PubMed