ECOG, Eastern Cooperative Oncology Group.
Karnofsky and Lansky performance scores are intended to be multiples of 10.
^a The conversion of the Lansky to ECOG scales is intended for National Cancer Institute reporting purposes only.

0

Fully active, able to carry on all predisease performance without restriction

100

Normal, no complaints, no evidence of disease

100

Fully active, normal

90

Able to carry on normal activity; minor signs or symptoms of disease

90

Minor restrictions in physically strenuous activity

1

Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light housework/office work

80

Normal activity with effort; some signs or symptoms of disease

80

Active, but tires faster than in previous phase

70

Cares for self, unable to carry on normal activity or do active work

70

Both greater restriction of play activity and less time spent in such activity than in previous phase

2

Ambulatory and capable of all self-care but unable to carry out any activities related to work. Up and about more than 50% of waking hours.

60

Requires occasional assistance, but is able to care for most of his/her needs

60

Up and around, but minimally active in play; keeps busy with quieter activities than in previous phase

50

Requires considerable assistance and frequent medical care

3

Capable of only limited self-care, confined to bed or chair more than 50% of waking hours

40

Disabled, requires special care and assistance

50

Gets dressed, but lies around much of the day; no active play; able to participate in quiet play and activities

30

Severely disabled, hospitalization indicated; death not imminent

4

Completely disabled. Cannot carry on any self-care; totally confined to bed or chair

20

Very sick, hospitalization indicated; death not imminent

40

Mostly in bed; participates in quiet activities

10

Moribund, fatal processes progressing rapidly

30

In bed; needs assistance even for quiet play

20

Often sleeping; play entirely limited to very passive activities

10

No play; does not even get out of bed

WHO, World Health Organization; RECIST, Response Evaluation Criteria in Solid Tumors; LD, longest diameter; CR, complete response; PR, partial response; PD, progressive disease; NC, no change; SD, stable disease.
^a Lesions that can only be measured unidimensionally are considered to be measurable (e.g., mediastinal adenopathy, malignant hepatomegaly).
From J Natl Cancer Inst 2000;92:179–181, with permission.

Measurability of lesions at baseline

1. Measurable, two-dimensional (product of LD and greatest perpendicular diameter)^a

2. Nonmeasurable/evaluable (e.g., lymphangitic pulmonary metastases abdominal masses)

1. Measurable, unidimensional (LD only, size with conventional techniques ≥20 mm; spiral computed tomography ≥10 mm)

2. Nonmeasurable: all other lesions, including small lesions. Evalua is not recommended.

Objective response

1. Measurable disease (change in sum of products of LDs and greatest perpendicular diameters; no maximum number of lesions specified)
CR: disappearance of all known disease, confirmed at ≥4 wk
PR: ≥50% decrease from baseline, confirmed at ≥4 wk
PD: ≥25% increase of one or more lesions, or appearance of new lesions
NC: neither PR nor PD criteria met

2. Nonmeasurable disease
CR: disappearance of all unknown disease, confirmed at ≥4 wk
PR: estimated decrease ≥50%, confirmed at ≥4 wk
PD: estimated increase ≥25% in existent lesions
NC: neither PR nor PD criteria met

1. Target lesions [change in sum of LDs, maximum of 5 per organ up to 10 totally (more than one organ)]
CR: disappearance of all target lesions, confirmed at ≥4 wk
PR: ≥30% decrease from baseline, confirmed at ≥4 wk
PD: ≥20% increase over smallest sum of target lesions observed, or appearance of new lesions
SD: neither PR nor PD criteria met

2. Nontarget lesions
CR: disappearance of all target lesions and normalization of tumor markers, confirmed at ≥4 wk
PD: unequivocal progression of nontarget lesions, or appearance of new lesions
NonPD: persistence of one or more nontarget lesions and/or tumor markers above normal limits

Overall response

1. Best response recorded in measurable disease

2. NC in nonmeasurable lesions will reduce a CR in measurable lesions to an overall PR

3. NC in nonmeasurable lesions will not reduce in a PR in measurable lesions

1. Best response recorded in measurable disease from treatment start to disease progression or recurrence

2. Non-PD in nontarget lesions(s) will reduce a CR in target lesions(s) to an overall PR

3. Non-PD in nontarget lesion(s) will not reduce a PR in target lesions(s)

Duration of response

1. CR
From: date CR criteria first met
To: date PD first noted

2. Overall response
From: date of start of treatment
To: date PD first noted

3. In patients who achieve only a PR, only the period of overall response should be recorded

1. Overall CR
From: date CR criteria first met
To: date recurrent disease first noted

2. Overall response
From: date CR or PR criteria first met (whichever status came first)
To: date recurrent disease or PD first noted

3. SD
From: date of start of treatment
To: date PD first noted

Amputee (approximate surface area of amputated part):

Hand and five fingers

3%

Foot

3%

Arm, lower

4%

Leg, lower

6%

Arm, upper

6%

Leg, thigh

12%