Buccal Mucosa Squamous Cell Carcinoma: Analysis of ECOG Performance Status and its Association with Sociodemographic, Socioeconomic, Clinico-Pathologic Factors and Overall Survival

Abstract

Introduction: Despite, progress in cancer therapeutics, survival remains very poor due to various factors. However, treatment decision making is an important factor for a better survival outcome. Aim: To evaluate Eastern Cooperative Oncology Group Performance Status (ECOG-PS) in buccal mucosa squamous cell carcinoma and its association with sociodemographic, socioeconomic, clinicopathologic factors and overall survival. Materials and Methods: This prospective study was conducted in the Regional Cancer Centre, Tamil Nadu between March 2013 and January 2016. Chi-square test and binary logistic regression were performed to evaluate the association between the covariates and ECOG-PS. Further, Kaplan-Meier and log-rank test were used for survival analysis. All statistical significance was set at p<0.05. Results: A total of 198 subjects which comprised 125 (63.1%) male and 73 (36.9%) female. In the study, demographic characteristics (Gender, Age, Body mass index and Risk habits) were failed to show the significance whereas socioeconomic status (p≤0.001) and clinicopathological features like cell differentiation (p=0.034), TNM stage (p≤0.001), lymph node status (p≤0.001) and metastasis (p≤0.001) exhibited significant association at p<0.05. Further, the presence of lymph node and metastasis had 2.27 fold and 1.053 fold risk of disease recurrence/death of subjects than negative lymph node and metastasis respectively. All the subjects were followed for an average of 18 months. Of 198 subjects, 24 (12.1%) reported recurrence and 7 (3.5%) were identified with disease-specific death and the rest of 167 (84.4%) were alive at last follow-up. The estimated overall survival rate was 48% and the study revealed a lower survival outcome of poor ECOG-PS than good ECOG-PS (p=0.046, p<0.05). Conclusion: The present study concludes that the subject’s physical performance score using ECOG-PS scale at diagnosis may help to identify aggressiveness of the disease and may help medical care requirements, specific therapeutic and rehabilitative interventions.

Keywords

• cancer therapeutics
• physical performance
• recurrence