ECOG Performance Status

Functional status for oncology treatment decisions — 0 to 5

Performance status

0 — Fully active, no restriction on pre-disease activity

1 — Restricted in strenuous activity, but ambulatory and able to do light work

2 — Ambulatory, self-caring, but unable to work; up > 50% of waking hours

3 — Limited self-care; confined to bed or chair > 50% of waking hours

4 — Completely disabled; no self-care; totally bed- or chair-bound

5 — Dead

Evidence

Original publication

Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Defined the ECOG performance status scale (0 fully active to 5 dead), used to stratify patients in oncology trials and to guide treatment intensity.

American Journal of Clinical Oncology, 1982

Open source

Guideline

ECOG PS 0–1 is generally required for most cytotoxic and combination regimens and for many clinical trials; PS ≥ 3 usually favours best supportive care or single-agent, lower-intensity treatment. It correlates with the Karnofsky index and is a strong independent prognostic factor.

Last reviewed: 2026-09

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