3.6 Performance Status (PS)1,2
Performance status (PS) is a method of assessing and indicating a patient’s general condition and is used to assess whether the patient can tolerate oncological treatment. PS is also an important prognostic factor.
For most cancers, survival is inversely proportional to PS.
PS can be quantified by several systems, with Eastern Cooperative Oncology Group (ECOG) and Karnofsky being the most widely used. Below is a list of PS grading in accordance with ECOG.
In order to be offered systemic oncology treatment, the patient should have an ECOG performance status of 2 or less, or Karnofsky PS of 70 or more.
PS grading according to ECOG and Karnofsky
| GRADE | ECOG PERFORMANCE STATUS |
|---|---|
| 0 | Fully active and able to continue with all functions that the patient was able to perform prior to the disease without restrictions |
| 1 | Restricted in physically strenuous activity but ambulatory and able to carry out light physical work such as light housework or office work |
| 2 | Ambulatory > half of the day and self-reliant but unable to perform work functions |
| 3 | In bed/chair > half of the day and only able to manage on his/her own to a limited extent |
| 4 | Fully confined to bed or chair and needs help with everything |
| 5 | Death |
| GRADE | ECOG PERFORMANCE STATUS |
|---|---|
| 100 | Normal, no complaints |
| 90 | Normal activity, mild signs or symptoms of disease |
| 80 | Normal activity, but with difficulty |
| 70 | Self-reliant, reduced activity, unable to carry out work |
| 60 | Ambulatory, needs some help but is largely self-reliant |
| 50 | Needs help and care, limited self-reliance |
| 40 | Disabled, dependent on care |
| 30 | Disabled, hospital admission |
| 20 | Severely ill, hospitalisation necessary |
| 10 | Moribund |
| 0 | Death |
References
- Oken, M.M., Creech, R.H., Tormey, D.C., Horton, J., Davis, T.E., McFadden, E.T., Carbone, P.P.: Toxicity And Response Criteria Of The Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649-655, 1982
- Karnofsky DA, Burchenal JH. In: Evaluation of chemotherapeutic agents. MacLeod CM, editor. New York: Columbia University Press; 1949. The clinical evaluation of chemotherapeutic agents in cancer; pp. 191–205
