Performance status

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ECOG performance status (WHO/Zubrod score)

Grade Description
0 Fully active, able to continue with all pre-disease activities without restriction.
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.
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.
3 Capable of only limited self-care. Confined to bed or chair more than 50% of waking hours.
4 Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair.
5 Dead.

Karnofsky performance scale

Condition Performance status % Comments
Able to carry on normal activity and to work. No special care needed. 100 Normal. No complaints. No evidence of disease.
90 Able to carry on normal activity. Minor signs or symptoms of disease.
80 Normal activity with effort. Some signs or symptoms of disease.
Unable to work. Able to live at home and care for most personal needs. A varying degree of assistance is needed. 70 Cares for self. Unable to carry on normal activity or to do active work.
60 Requires occasional assistance, but is able to care for most of personal needs.
50 Requires considerable assistance and frequent medical care.
Unable to care for self. Requires equivalent of institutional or hospital care. Disease may be progressing rapidly. 40 Disabled. Requires special care and assistance.
30 Severely disabled. Hospital admission is indicated although death is not imminent.
20 Hospitalization necessary. Very sick, active supportive treatment necessary.
10 Moribund; fatal processes progressing rapidly.
0 Dead.

Comparing Karnofsky performance scale & ECOG performance status

Note: There are other sources that break these comparisons down to a finer degree, but there are disparities between them, and I could not find a more suitable head-to-head comparison in the primary literature to reference.

  • Karnofsky score of 80-100% = ECOG performance status of 0 or 1
  • Karnofsky score of 60-70% = ECOG performance status of 2
  • Karnofsky score of 10-50% = ECOG performance status of 3 or 4
  • Karnofsky score of 0% = ECOG performance status of 5

Lansky play-performance scale for pediatric patients

This scale may be used with children age 1-16 who have any type of malignancy. It may be used for both inpatients & outpatients, and for patients undergoing active treatment as well as long-term follow-up. It is rated by parents based on their child's activity over the past week. Parents fill out the assessment based on the directions on the form, and the form is readministered over time to assess for changes in performance status.

An excerpt of the relevant directions for parents is as follows:

"Think about your child's play and activity over the past week. Think about both good days and bad days. Average out this period. Now read the descriptions and pick the one that best describes your child's play during the past week."
Rating Description
100 fully active, normal
90 minor restrictions with strenuous physical activity
80 active, but gets tired more quickly
70 both greater restriction of, and less time spent in, active play
60 up and around, but minimal active play; keeps busy with quieter activities
50 lying around much of the day, but gets dressed; no active play; participates in all quiet play and activities
40 mostly in bed; participates in quiet activities
30 stuck in bed; needs help even for quiet play
20 often sleeping; play is entirely limited to very passive activities
10 does not play nor get out of bed
0 unresponsive

References

  1. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982 Dec;5(6):649-55. link to original article PubMed
  2. ECOG Performance Status (contains ECOG performance scale) Eastern Cooperative Oncology Group, Robert Comis M.D., Group Chair.
  3. Schag CC, Heinrich RL, Ganz PA. Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncol. 1984 Mar;2(3):187-93. link to original article (contains Karnofsky performance scale) PubMed
  4. Lansky SB, List MA, Lansky LL, Ritter-Sterr C, Miller DR. The measurement of performance in childhood cancer patients. Cancer. 1987 Oct 1;60(7):1651-6. link to original article (contains Lansky performance scale) PubMed
  5. Buccheri G, Ferrigno D, Tamburini M. Karnofsky and ECOG performance status scoring in lung cancer: a prospective, longitudinal study of 536 patients from a single institution. Eur J Cancer. 1996 Jun;32A(7):1135-41. link to original article PubMed
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