David Goldenberg1, Heath Mackley2, Wayne Koch3, Darrin V Bann4, Eric W Schaefer5, Christopher S Hollenbeak6. 1. Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, United States. Electronic address: dgoldenberg@hmc.psu.edu. 2. Department of Radiology, The Pennsylvania State University, College of Medicine, Hershey, PA, United States. 3. Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University, Baltimore, MD, United States. 4. Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, United States. 5. Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, United States. 6. Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, United States; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, United States.
Abstract
BACKGROUND: We investigate treatment selection for oral cavity and oropharyngeal (OC&OP) cancers to understand factors that influence treatment selection. METHODS: We studied 7023 patients, ⩾66 years, diagnosed with a first primary OC&OP cancer using SEER-Medicare data. Multinomial logistic regression was to model treatment selection, controlling for other factors. RESULTS: Most patients with OC cancer were treated with surgery alone (56.5%); most patients with OP cancer were treated with chemotherapy and radiation (28.9%). Age, stage and site were the most important predictors of treatment selection. As age increased from 70 to 81 (the interquartile range), treatment shifted toward surgery alone (OR=1.26; CI: 1.08-1.46) and no treatment (OR=1.5, 95% CI: 1.25-1.80), and away from combined surgery, radiation and treatments involving chemotherapy. CONCLUSIONS: Age, stage, and site are the most important determinants of treatment selection for patients with OC&OP cancers. Increasing age and stage drive treatment toward non-surgical options and no treatment at all.
BACKGROUND: We investigate treatment selection for oral cavity and oropharyngeal (OC&OP) cancers to understand factors that influence treatment selection. METHODS: We studied 7023 patients, ⩾66 years, diagnosed with a first primary OC&OP cancer using SEER-Medicare data. Multinomial logistic regression was to model treatment selection, controlling for other factors. RESULTS: Most patients with OC cancer were treated with surgery alone (56.5%); most patients with OP cancer were treated with chemotherapy and radiation (28.9%). Age, stage and site were the most important predictors of treatment selection. As age increased from 70 to 81 (the interquartile range), treatment shifted toward surgery alone (OR=1.26; CI: 1.08-1.46) and no treatment (OR=1.5, 95% CI: 1.25-1.80), and away from combined surgery, radiation and treatments involving chemotherapy. CONCLUSIONS: Age, stage, and site are the most important determinants of treatment selection for patients with OC&OP cancers. Increasing age and stage drive treatment toward non-surgical options and no treatment at all.
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