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Assess functional status in cancer patients using the Eastern Cooperative Oncology Group scale
Performance Status
Fully Active
Karnofsky Equivalent
90-100
Treatment Eligibility
Eligible for all treatment protocols
| ECOG | Karnofsky | Description |
|---|---|---|
| 0 | 90-100 | Fully active, no restrictions |
| 1 | 70-80 | Restricted in strenuous activity |
| 2 | 50-60 | Ambulatory >50% of time |
| 3 | 30-40 | Limited self-care, in bed >50% of time |
| 4 | 10-20 | Completely disabled |
| 5 | 0 | Dead |
The Eastern Cooperative Oncology Group (ECOG) Performance Status is a widely used scale to assess how a patient's disease is progressing and how it affects their daily living abilities. It ranges from 0 (fully active) to 5 (dead) and is a key factor in determining treatment eligibility and prognosis.
ECOG Performance Status is crucial for:
ECOG Performance Status is one of the strongest prognostic factors in oncology. Higher ECOG scores (worse functional status) are associated with shorter survival across most cancer types. Many prognostic models incorporate ECOG status as a key variable.
When assessing ECOG Performance Status:
Both assess functional status, but ECOG uses a simpler 0-5 scale while Karnofsky uses 0-100. ECOG is more commonly used in clinical trials and daily practice due to its simplicity. The scales can be converted approximately using established correlations.
Yes, ECOG status can improve if treatment is effective and disease burden decreases. It can also worsen during active treatment due to side effects or with disease progression. Regular reassessment is important.
Most chemotherapy protocols require ECOG 0-2. ECOG 3-4 patients are generally considered too frail for standard chemotherapy, though individual decisions depend on cancer type, treatment goals, and patient preferences.
ECOG should be assessed at baseline, before each treatment cycle, and whenever there's a clinical change. In clinical trials, it's typically documented at each visit. More frequent assessment may be needed for patients with rapidly changing functional status.
ECOG involves some subjectivity, though it's based on observable functional abilities. Inter-observer agreement is generally good when healthcare providers are properly trained. Patient self-assessment can differ from physician assessment.
Yes, ECOG is a powerful prognostic factor across cancer types. Generally, each 1-point increase in ECOG score is associated with significantly worse survival. ECOG 3-4 patients typically have median survival measured in weeks to months rather than years.
Yes, medications can impact functional status. Pain medications, sedatives, and drugs causing fatigue may worsen ECOG score. Effective cancer treatment, steroids, and symptom management can improve it. Consider medication effects when assessing.
While not the only criterion, ECOG 3-4 status supports hospice eligibility when combined with other factors like declining trajectory and limited life expectancy. ECOG helps document functional decline necessary for hospice certification.