ECOG Score for Performance Status Calculator

How does this ECOG score for performance status calculator work?

This is a health tool that evaluates cancer patient functional status and clinically stratifies these patients’ ability to undergo chemotherapy.

The original study by the Eastern Cooperative Oncology Group (ECOG) now part of the ECOG-ACRIN Cancer Research Group, published in 1960, comprised of only 5 points and also known as the Zubrod score (after C. Gordon Zubrod), while the second version, published in 1982, represents a performance status evaluation on a scale from 0 to 6, 0 indicating a normal patient and 6 indicating death.

The ECOG comes after several other models such as the Karnofsky score and the pediatric Lansky score. It is actually considered to be a more simplified version of the KPS.

The evaluation is simple, with the clinician trying to assign the current situation of the patient to one of the following stages.

■ 0 – Asymptomatic (Fully active, able to carry on all pre-disease activities without restriction);

■ 1 – Symptomatic but completely ambulatory (Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature. For example, light housework, office work);

■ 2 – Symptomatic, <50% in bed during the day (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 – Symptomatic, >50% in bed, but not bedbound (Capable of only limited self-care, confined to bed or chair 50% or more of waking hours);

■ 4 – Bedbound (Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair);

■ 5 – Death.

The ECOG status quantifies the functional status of malignant patients and is used as a prognostic tool in several types of cancers.

As a performance status scale it describes the need for care and or ambulatory status.

Being put under question in an inter-observer variability study on a population of 100 patients with 3 oncologists, the ECOG score performed sensibly with:

■ Total unanimity observed in 40 cases;

■ Unanimity between 2 observers in 53 cases;

■ Total disagreement in the other 7 cases.

Often, clinical trials employ scores such as the ECOG or the KPS in evaluating the general health of prospective participants and trial protocols state exactly the stages they are interested to receive.

By comparison to the KPS, the stages are similar with one stage of the ECOG being similar to two consecutive stages of the Karnofsky, i.e 0 with 0 and 1, 1 with 2 and 3 of the latter.

References

1) Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP. (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol; 5(6):649-55.

2) Sorensen JB, Klee M, Palshof T, Hansen HH. (1993) Performance status assessment in cancer patients. An inter-observer variability study. Br J Cancer; 67(4): 773–775.

3) Blagden SP, Charman SC, Sharples LD, Magee LRA, Gilligan D. (2003) Performance status score: do patients and their oncologists agree? Br J Cancer; 89(6): 1022–1027.