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Analysis of ECOG performance status in head and neck squamous cell carcinoma patients: association with sociodemographical and clinical factors, and overall survival

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Abstract

Purpose

In the present study, we analyzed sociodemographical and clinical factors, and the Eastern Cooperative Oncology Group performance status (ECOG-PS) scale in head and neck squamous cell carcinoma (HNSCC) patients. We evaluated the impact of a range of variables on overall survival.

Methods

We investigated a sample of HNSCC patients (n = 671), using sociodemographical and clinical information, and survival data collected from a review of epidemiological, clinical, and treatment reports. Statistical associations were analyzed by bivariate and multivariate statistical tests. Statistical significance was set at p < 0.05.

Results

Of patients 85.4% recorded good ECOG-PS scores. Poor ECOG-PS scores were associated with the covariates indicative of dysphagia [odd ratios (OR) = 2.660, CI 95% = 1.661–4.260, p = 0.000] and large-size malignant disease (T3–T4; OR = 5.337, CI 95% = 2.251–12.652, p = 0.000). Overall survival analysis revealed that ECOG-PS scores (OR = 1.879, CI 95% = 1.162–3.038, p = 0.010), tumor size (OR = 1.665, CI 95% = 1.035–2.680, p = 0.036), and the presence of cervical metastasis (OR = 3.145, CI 95% = 2.008–4.926, p = 0.000) were independent predictors.

Conclusion

Evaluation of physical consumption in head and neck cancer patients at diagnosis may indicate a more aggressive type of malignant disease. Thus, the ECOG-PS scale may help to identify HNSCC patients in need of rapid referral, who may benefit from specific therapeutic and rehabilitative interventions.

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Acknowledgments

The authors are grateful for the support from Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).

Conflict of interest

The authors declare no competing interests.

Author information

Authors and Affiliations

  1. Health Science Programme. Health Research Laboratory. Department of Dentistry and Medicine, Universidade Estadual de Montes Claros, 39401-001, Montes Claros, Minas Gerais, Brazil

    Gefter Thiago Batista Corrêa, Gabriela Alencar Bandeira, Bruna Gonçalves Cavalcanti, João Felício Rodrigues Neto, André Luiz Sena Guimarães & Alfredo Maurício Batista De Paula

  2. Department of Medicine, Universidade Estadual de Montes Claros, 39401-001, Montes Claros, Minas Gerais, Brazil

    Francis Balduíno Guimarães Santos

  3. Department of Dentistry, Universidade Estadual de Montes Claros, 39401-001, Montes Claros, Minas Gerais, Brazil

    Desirée Sant’Ana Haikal

  4. Programa de Pós-graduação em Ciências da Saúde—Laboratório de Pesquisa em Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros, Avenida. Cula Mangabeira, 562, bairro Santo Expedito, Montes Claros, CEP 39401-001, Minas Gerais, Brazil

    Alfredo Maurício Batista De Paula

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  1. Gefter Thiago Batista Corrêa
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Correspondence to Alfredo Maurício Batista De Paula.

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Relevance of the manuscript

Head and neck squamous cell carcinoma (HNSCC) represents the sixth most common type of human cancer, and is responsible for high death rates worldwide every year. The Eastern Cooperative Oncology Group performance status (ECOG-PS) scale evaluates the physical functioning of cancer patients, and frequently exhibits a high predictive value. In this study, we evaluated the association between accessible sociodemographical and clinical factors, and their effects on overall survival in a large sample of HNSCC patients. Multivariate analysis revealed that poor status performance was associated with clinical factors indicative of a high aggressiveness of HNSCC, such as large-size tumor lesions and dysphagia. Poor ECOG-PS scores, the occurrence of locoregional metastasis, and large-size tumors were associated with a poor prognosis. Thus, the ECOG-PS scale may help to identify HNSCC patients in need of rapid referral to health care centers, and could facilitate an improvement in treatments and aesthetical–functional rehabilitation strategies.

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Corrêa, G.T.B., Bandeira, G.A., Cavalcanti, B.G. et al. Analysis of ECOG performance status in head and neck squamous cell carcinoma patients: association with sociodemographical and clinical factors, and overall survival. Support Care Cancer 20, 2679–2685 (2012). https://doi.org/10.1007/s00520-012-1386-y

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