Karnofsky performance status
Functional status (0–100 %) with ECOG equivalent
- ECOG-ACRIN (public domain)
Sources last checked: 2026-10-13
Karnofsky performance status
Functional status (0–100 %) with ECOG equivalent
The KPS→ECOG mapping is the commonly used comparison shown by ECOG-ACRIN, not a validated conversion; other published mappings place the boundaries differently.
Interpretation
| 0 — dead (ECOG 5) | ECOG equivalent 5. |
|---|---|
| 10–20 — ECOG 4 | Moribund or very sick; at 20 the scale describes hospital admission and active supportive care as necessary. |
| 30–40 — ECOG 3 | Disabled; needs special care and assistance. |
| 50–60 — ECOG 2 | Needs occasional to considerable assistance. |
| 70–80 — ECOG 1 | Self-caring; normal activity only with effort or not possible. |
| 90–100 — ECOG 0 | Normal activity with at most minor symptoms. |
What is the Karnofsky performance status?
The Karnofsky Performance Status (KPS) rates functional ability in 10-point steps from 100 (normal, no evidence of disease) to 0 (dead). It was introduced by Karnofsky and Burchenal in 1949 to evaluate chemotherapy and remains widely used in neuro-oncology, radiotherapy and palliative care. This tool also shows the ECOG grade that ECOG-ACRIN lists alongside each KPS level.
When to use it
- When a protocol or score asks for KPS rather than ECOG (e.g. many neuro-oncology and radiotherapy pathways)
- To describe functional status with finer steps than the six-level ECOG scale
- To translate between KPS and ECOG when comparing trial populations
When not to use it
- As a precise conversion to ECOG for eligibility decisions — check the protocol's own definition
- In children, where the Lansky play-performance scale is used instead
How it is calculated
| Criterion | Points |
|---|---|
| Which description fits best? | |
| 100 — Normal, no complaints, no evidence of disease | 100 |
| 90 — Normal activity; minor signs or symptoms | 90 |
| 80 — Normal activity with effort; some signs or symptoms | 80 |
| 70 — Cares for self; unable to carry on normal activity or active work | 70 |
| 60 — Requires occasional assistance; cares for most personal needs | 60 |
| 50 — Requires considerable assistance and frequent medical care | 50 |
| 40 — Disabled; requires special care and assistance | 40 |
| 30 — Severely disabled; hospital admission indicated, death not imminent | 30 |
| 20 — Very sick; hospital admission and active supportive care necessary | 20 |
| 10 — Moribund | 10 |
| 0 — Dead | 0 |
Clinical pearls and limitations
- The KPS→ECOG mapping is the commonly used comparison shown by ECOG-ACRIN, not a validated conversion; other published mappings place the boundaries differently.
- The scale moves in steps of 10; intermediate values are not defined.
- 70 marks the point at which a patient can no longer work or carry on normal activity but still cares for themselves.
- Several KPS→ECOG mappings exist; the one shown here is the comparison published by ECOG-ACRIN.
Frequently asked questions
What is a Karnofsky score of 70?
The patient cares for themselves but cannot carry on normal activity or do active work. ECOG-ACRIN places it alongside ECOG 1.
Is Karnofsky 50 the same as ECOG 2?
In the ECOG-ACRIN comparison KPS 50–60 corresponds to ECOG 2, but the descriptions are not identical — KPS 50 already implies considerable assistance.
Which is better, Karnofsky or ECOG?
Neither is more valid in general. Use the scale your protocol, trial or score was built on; ECOG is more common in medical oncology.
Evidence and guidelines
- Primary source: Karnofsky DA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM, ed. Evaluation of Chemotherapeutic Agents. Columbia University Press; 1949:191-205. Scale text and ECOG comparison as published by ECOG-ACRIN.
- Oken MM et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982;5(6):649-655.
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