Buccal Mucosa Squamous Cell Carcinoma: Analysis of ECOG Performance Status and its Association with Sociodemographic, Socioeconomic, Clinico-Pathologic Factors and Overall Survival
Published: March 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/31698.12688
Padma Ramasamy, Amitkumar Kalaivani, Sivapatham Sundaresan
1. Research Scholar, Department of Medical Research, SRM Medical College Hospital and Research Centre,
SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India.
2. Assistant Professor, Department of Pathology, SRM Medical College Hospital and Research Centre,
SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India.
3. Assistant Professor, Department of Medical Research, SRM Medical College Hospital and Research Centre,
SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India.
Correspondence
Dr. Padma Ramasamy,
Research Scholar, Department of Medical Research, SRM Medical College Hospital and Research Centre,
SRM Institute of Science and Technology, Kattankulathur-603203, Tamil Nadu, India.
E-mail: drpadmaramphd@gmail.com
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.
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