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KPS vs ECOG Conversion — SCE Medical Oncology MCQ

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EasySupportive & Palliative OncologyKPS vs ECOG ConversionSCE Medical Oncology

A 60-year-old man with cancer asks his oncologist about prognostication using the Karnofsky Performance Status (KPS) scale versus ECOG Performance Status (PS). What is the relationship between these two scales?

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Correct answer: B — KPS (0-100) and ECOG PS (0-5) are inversely correlated and can be approximately converted: ECOG 0 ≈ KPS 100; ECOG 1 ≈ KPS 80-90; ECOG 2 ≈ KPS 60-70; ECOG 3 ≈ KPS 40-50; ECOG 4 ≈ KPS 10-30; ECOG 5 ≈ KPS 0 (dead) — ECOG PS is more commonly used in UK practice

Both scales assess functional status but use different formats: KPS (Karnofsky, 1948) = 0-100 scale (100 = normal, 0 = dead), predominantly used in North America. ECOG PS (Zubrod/WHO, 1982) = 0-5 scale (0 = fully active, 5 = dead), predominantly used in UK/European practice. Clinical trials may use either scale (check protocol). Approximate conversion: ECOG 0 = KPS 90-100; ECOG 1 = KPS 70-80; ECOG 2 = KPS 50-60. Performance status is the strongest independent predictor of treatment tolerance, response and survival across all cancer types.

Reference: ESMO 2024; NICE NG; Oken et al Am J Clin Oncol 1982; Karnofsky et al Cancer 1948