Performance status: ECOG and Karnofsky
How to score ECOG (WHO) and Karnofsky performance status and the Australia-modified Karnofsky (AKPS), with worked cases; how they convert, why they predict survival and treatment benefit, where they appear in prognostic scores, trials and PBS criteria, and when a poor score shouldn't rule out treatment.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Performance status scores what a person can do in a day, which predicts survival and how well they tolerate treatment better than most tumour factors.
- ECOG (also called WHO or Zubrod) runs 0 to 5. Karnofsky (KPS) runs 100 to 0 in steps of 10. The AKPS is the Australian version used in palliative care.
- Most chemotherapy trials enrol ECOG 0 to 1, so evidence for ECOG 2 is thin and for ECOG 3 to 4 almost absent.
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Sources
- Oken MM et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982;5:649-55Eastern Cooperative Oncology Group (Am J Clin Oncol), 1982 (current scale, ECOG-ACRIN)
- ECOG performance status scaleECOG-ACRIN Cancer Research Group
- Abernethy AP et al. The Australia-modified Karnofsky Performance Status (AKPS) scale: a revised scale for contemporary palliative care clinical practice. BMC Palliat Care 2005;4:7AU/NZBMC Palliative Care, 2005
- Schnipper LE et al. American Society of Clinical Oncology identifies five key opportunities to improve care and reduce costs: the top five list for oncology. J Clin Oncol 2012;30:1715-24American Society of Clinical Oncology, 2012
- eviQ Cancer Treatments Online (ECOG performance status in protocol eligibility and day-of-treatment assessment)AU/NZCancer Institute NSW
- Palliative Care Outcomes Collaboration (PCOC) assessment tools, including AKPSAU/NZUniversity of Wollongong, Australian Health Services Research Institute
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy