Joan Lop1, Cristina Valero2, Jacinto García1, Miquel Quer1, Ian Ganly2, Jatin P Shah2,3, Snehal G Patel2, Xavier León1,4. 1. Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. 2. Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY. 3. Department of Oncology, Radiotherapy, and Plastic Surgery, Sechenov University, Moscow, Russia. 4. Oncogenesis and Antitumor Drugs Group, Biomedical Research Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
Abstract
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.
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.
Authors: Daniella Karassawa Zanoni; Pablo H Montero; Jocelyn C Migliacci; Jatin P Shah; Richard J Wong; Ian Ganly; Snehal G Patel Journal: Oral Oncol Date: 2019-02-15 Impact factor: 5.337
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Authors: Neil M Woody; Matthew C Ward; Shlomo A Koyfman; Chandana A Reddy; Jessica Geiger; Nikhil Joshi; Brian Burkey; Joseph Scharpf; Eric Lamarre; Brandon Prendes; David J Adelstein Journal: Int J Radiat Oncol Biol Phys Date: 2017-03-18 Impact factor: 7.038
Authors: Melina J Windon; Gypsyamber D'Souza; Eleni M Rettig; William H Westra; Annemieke van Zante; Steven J Wang; William R Ryan; Wojciech K Mydlarz; Patrick K Ha; Brett A Miles; Wayne Koch; Christine Gourin; David W Eisele; Carole Fakhry Journal: Cancer Date: 2018-04-30 Impact factor: 6.860