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Does age influence disease‐specific survival in patients with squamous cell carcinomas of the head and neck?
Author(s) -
Lop Joan,
Valero Cristina,
García Jacinto,
Quer Miquel,
Ganly Ian,
Shah Jatin P.,
Patel Snehal G.,
León Xavier
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25895
Subject(s) - medicine , head and neck squamous cell carcinoma , confidence interval , retrospective cohort study , cohort , oncology , head and neck , basal cell , disease , head and neck cancer , radiation therapy , surgery
Background and Objectives The number of patients diagnosed with head and neck squamous cell carcinoma (HNSCC) at an advanced age has increased. The aim of this study is to evaluate the age at which disease‐specific survival (DSS) significantly decreases in HNSCC. Methods We performed a retrospective study of 5469 patients with HNSCC treated at our center (1985‐2016). External validation with 2082 oral squamous cell carcinomas from a collaborative institution from another continent was performed. Results We observed an orderly decrease in overall survival as age at diagnosis increased. There were no differences in DSS based on age for patients <80 years old ( P = .623), while older patients had a significant decrease in DSS. These results were validated in the independent dataset. In a multivariable analysis performed in the test set, compared to patients <80 years old, patients between 80 to 85 had a 1.50 times higher risk of disease‐specific death (95% confidence interval [CI]: 1.19‐1.89; P = .001), and patients >85 had a 2.19 times higher risk (95% CI: 1.68‐2.87; P < .001). Conclusions DSS started to significantly decrease in HNSCC at 80 years old. These findings, validated in an independent cohort, indicate that chronological age on its own should not withhold curative treatment in the majority of patients with HNSCC.