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What Is Performance Status?

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Updated June 19, 2014

Question: What Is Performance Status?
Answer:

Performance status is a measure of how well a person is able to carry on ordinary daily activities while living with cancer. Understanding how well someone will do with treatment depends on the stage of the cancer, but also on his or her general health and ability to manage their care. Measuring performance status can be helpful in many ways:

  • To determine if someone is in reasonable health to tolerate treatments such as chemotherapy, surgery, or radiation therapy.
  • As selection criteria for clinical trials. Many clinical trials require patients to have a good performance status before trying an experimental treatment.
  • To evaluate an individual's response to treatment
  • To see if/how a cancer is progressing
  • To estimate prognosis

Performance Scales

Two primary performance scales are used to measure performance status for those living with cancer: the Eastern Co-operative Oncology Group (ECOG)/WHO system, and the Karnofsky performance score:

ECOG/WHO Performance Status

  • 0 – Fully active, no restrictions on activities
  • 1 – Unable to do strenuous activities, but able to carry out light housework and sedentary activities
  • 2 – Able to walk and manage self-care, but unable to work. Out of bed more than 50% of waking hours
  • 3 – Confined to bed or a chair more than 50% of waking hours. Capable of limited self-cares
  • 4 – Completely disabled. Totally confined to a bed or chair. Unable to do any self-care
  • 5 – Death

Karnofsky Performance Status

  • 100 – Normal, no symptoms, or evidence of disease
  • 90 – Minor symptoms, but able to carry on normal activities
  • 80 – Some symptoms, normal activity requires effort
  • 70 – Unable to carry on normal activities, but able to care for self
  • 60 – Needs frequent care for most needs, some occasional assistance with self-care
  • 50 – Needs considerable assistance with self-care, frequent medical care
  • 40 – Disabled; needs special care and assistance
  • 30 – Severely disabled; hospitalized
  • 20 – Very ill; significant supportive care is needed
  • 10 – Actively dying
  • 0 – Death

Sources:

Ando, M. et al. Prognostic value of performance status assessed by patients themselves, nurses, and oncologists in advanced non-small cell lung cancer. British Journal of Cancer. 2001. 85:1634-1639.

Oken, M. et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology. 1982. 5(6):649-656.

Yates, J. et al. Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer. 1980. 45(8):2220-4.

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