Ching-Chieh Yang1,2,3, Yu-Chieh Su4,5, Yu-Wei Lin1,2, Chung-I Huang6, Ching-Chih Lee7,8,9,10. 1. Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan. 2. Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan. 3. Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan. 4. Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 5. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 6. Department of Radiation Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan. 7. Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 8. Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan. 9. School of Medicine, National Yang-Ming University, Taipei, Taiwan. 10. Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.
Abstract
OBJECTIVES: To assess the impact of age on the survival of patients with head and neck squamous cell carcinoma (HNSCC) using different statistical methods. DESIGN: A retrospective population-based study. SETTING: Surveillance, Epidemiology, and End Results database. SUBJECTS AND METHODS: A total of 28 639 patients with newly diagnosed HNSCC were enrolled between 1 January 2007 and 31 December 2013. The effect of age on 5-year disease-specific survival was calculated using a Kaplan-Meier method and compared using log-rank tests. A Cox proportional hazards model was used for a multivariate analysis. A classification and regression tree (CART) analysis that partitioned patients with significantly different Kaplan-Meier curves was introduced to identify the important cancer-related parameters influencing survival. RESULTS: Uni- and multivariate analyses indicated that patients who were older than 60 years had poorer 5-year disease-specific survival regardless of tumour subsite and tumor-node-metastasis (TNM) stage. However, the CART analysis determined that age played only a minor role in survival after comparing with other prognosticators. The relative importance of age using the Gini index was as follows: 3.21% for oral cancer, 8.32% for oropharyngeal cancer, 2.56% for hypopharyngeal cancer and 16.51% for laryngeal cancer. CONCLUSIONS: Different to traditional statistical methods, the CART analysis which was used to identify homogeneous populations revealed that the impact of age varied for different patient groups according to the presence or absence of other prognosticators. This important information could help to guide our clinical decisions and future researches.
OBJECTIVES: To assess the impact of age on the survival of patients with head and neck squamous cell carcinoma (HNSCC) using different statistical methods. DESIGN: A retrospective population-based study. SETTING: Surveillance, Epidemiology, and End Results database. SUBJECTS AND METHODS: A total of 28 639 patients with newly diagnosed HNSCC were enrolled between 1 January 2007 and 31 December 2013. The effect of age on 5-year disease-specific survival was calculated using a Kaplan-Meier method and compared using log-rank tests. A Cox proportional hazards model was used for a multivariate analysis. A classification and regression tree (CART) analysis that partitioned patients with significantly different Kaplan-Meier curves was introduced to identify the important cancer-related parameters influencing survival. RESULTS: Uni- and multivariate analyses indicated that patients who were older than 60 years had poorer 5-year disease-specific survival regardless of tumour subsite and tumor-node-metastasis (TNM) stage. However, the CART analysis determined that age played only a minor role in survival after comparing with other prognosticators. The relative importance of age using the Gini index was as follows: 3.21% for oral cancer, 8.32% for oropharyngeal cancer, 2.56% for hypopharyngeal cancer and 16.51% for laryngeal cancer. CONCLUSIONS: Different to traditional statistical methods, the CART analysis which was used to identify homogeneous populations revealed that the impact of age varied for different patient groups according to the presence or absence of other prognosticators. This important information could help to guide our clinical decisions and future researches.
Authors: Filippo Marchi; Francesco Missale; Fabiola Incandela; Marta Filauro; Francesco Mazzola; Francesco Mora; Alberto Paderno; Giampiero Parrinello; Cesare Piazza; Giorgio Peretti Journal: Laryngoscope Investig Otolaryngol Date: 2019-08-28
Authors: Martine F van der Kamp; Friso O W Muntinghe; René S Iepsma; Boudewijn E C Plaat; Bernard F A M van der Laan; Ayat Algassab; Roel J H M Steenbakkers; Max J H Witjes; Boukje A C van Dijk; Geertruida H de Bock; Gyorgy B Halmos Journal: Eur Arch Otorhinolaryngol Date: 2020-06-15 Impact factor: 2.503