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Published in: European Archives of Oto-Rhino-Laryngology 1/2019

01-01-2019 | Head & Neck

Impact of age on elderly patients with oral cancer

Authors: Akshat Malik, Aseem Mishra, Prashant Chopda, Hitesh Singhvi, Sudhir Nair, Deepa Nair, Sarbani Ghosh Laskar, Kumar Prabhash, Jai Prakash Agarwal, Pankaj Chaturvedi

Published in: European Archives of Oto-Rhino-Laryngology | Issue 1/2019

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Abstract

Introduction

In this study we have tried to analyze the impact of age on various clinico-pathological parameters, treatment completion and subsequent survival in older patients.

Materials and methods

This is a retrospective analysis of 140 elderly (> 65 years) patients of oral cancer operated between January 2012 and December 2013. The patients were divided into two groups based upon their age that ≤ 70 years and > 70 years.Association of distribution of various clinico-pathological factors between different groups was assessed by using Chi-square test. Survival analysis was done using Kaplan Meir analysis. Univariate and multivariate analysis were performed.

Results

The two groups had similar distribution of various clinico-pathological factors. Disease free survival for the group ≤ 70 and > 70 years was 37.6 months and 36.4 months (p < 0.594). 13.5% and 7.8% patients > 70 years and ≤ 70 years were either advised or received sub-optimal adjuvant therapy (p < 0.002).

Conclusion

There is no difference distribution of various clinico-pathological factors and survival in patients of oral cancer ≤ 70 and > 70 years of age. Age did not affect survival. Majority of patients could complete the adjuvant therapy advised. Still, significantly more number of patients > 70 years could not receive/complete appropriate adjuvant therapy. Thus treatment needs to be tailored keeping in mind the individual’s performance status and the co-morbidities.
Literature
1.
go back to reference Krishna Rao SV, Mejia G, Roberts-Thomson K, Logan R (2013) Epidemiology of oral cancer in Asia in the past decade–an update (2000–2012). Asian Pac J Cancer Prev APJCP 14(10):5567–5577CrossRefPubMed Krishna Rao SV, Mejia G, Roberts-Thomson K, Logan R (2013) Epidemiology of oral cancer in Asia in the past decade–an update (2000–2012). Asian Pac J Cancer Prev APJCP 14(10):5567–5577CrossRefPubMed
2.
go back to reference Swaminathan D, Swaminathan V (2015 Dec) Geriatric oncology: problems with under-treatment within this population. Cancer Biol Med 12(4):275–283PubMedPubMedCentral Swaminathan D, Swaminathan V (2015 Dec) Geriatric oncology: problems with under-treatment within this population. Cancer Biol Med 12(4):275–283PubMedPubMedCentral
4.
go back to reference Sarini J, Fournier C, Lefebvre JL, Bonafos G, Van JT, Coche-Dequéant B (2001 Sep) Head and neck squamous cell carcinoma in elderly patients: a long-term retrospective review of 273 cases. Arch Otolaryngol Head Neck Surg 127(9):1089–1092CrossRefPubMed Sarini J, Fournier C, Lefebvre JL, Bonafos G, Van JT, Coche-Dequéant B (2001 Sep) Head and neck squamous cell carcinoma in elderly patients: a long-term retrospective review of 273 cases. Arch Otolaryngol Head Neck Surg 127(9):1089–1092CrossRefPubMed
5.
go back to reference Paleri V, Wight RG, Silver CE, Haigentz M, Takes RP, Bradley PJ et al (2010 Oct) Comorbidity in head and neck cancer: a critical appraisal and recommendations for practice. Oral Oncol 46(10):712–719CrossRefPubMed Paleri V, Wight RG, Silver CE, Haigentz M, Takes RP, Bradley PJ et al (2010 Oct) Comorbidity in head and neck cancer: a critical appraisal and recommendations for practice. Oral Oncol 46(10):712–719CrossRefPubMed
6.
go back to reference Sanabria A, Carvalho AL, Vartanian JG, Magrin J, Ikeda MK, Kowalski LP (2007 Apr) Comorbidity is a prognostic factor in elderly patients with head and neck cancer. Ann Surg Oncol 14(4):1449–1457CrossRefPubMed Sanabria A, Carvalho AL, Vartanian JG, Magrin J, Ikeda MK, Kowalski LP (2007 Apr) Comorbidity is a prognostic factor in elderly patients with head and neck cancer. Ann Surg Oncol 14(4):1449–1457CrossRefPubMed
7.
go back to reference Gugić J, Strojan P (2012 Aug) Squamous cell carcinoma of the head and neck in the elderly. Rep Pract Oncol Radiother 10(1):16–25 18(CrossRef Gugić J, Strojan P (2012 Aug) Squamous cell carcinoma of the head and neck in the elderly. Rep Pract Oncol Radiother 10(1):16–25 18(CrossRef
8.
go back to reference Morgan RF, Hirata RM, Jaques DA, Hoopes JE (1982 Oct) Head and neck surgery in the aged. Am J Surg 144(4):449–451CrossRefPubMed Morgan RF, Hirata RM, Jaques DA, Hoopes JE (1982 Oct) Head and neck surgery in the aged. Am J Surg 144(4):449–451CrossRefPubMed
9.
go back to reference Pignon T, Horiot J-C, Bogaert WV den, Glabbeke MV, Scalliet P (1996) No age limit for radical radiotherapy in head and neck tumours. Eur J Cancer 32A(12):2075–2081CrossRefPubMed Pignon T, Horiot J-C, Bogaert WV den, Glabbeke MV, Scalliet P (1996) No age limit for radical radiotherapy in head and neck tumours. Eur J Cancer 32A(12):2075–2081CrossRefPubMed
10.
go back to reference Pignon J-P, le Maître A, Maillard E, Bourhis J, MACH-NC Collaborative Group (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92(1):4–14CrossRef Pignon J-P, le Maître A, Maillard E, Bourhis J, MACH-NC Collaborative Group (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92(1):4–14CrossRef
11.
go back to reference Blanchard P, Baujat B, Holostenco V, Bourredjem A, Baey C, Bourhis J et al (2011) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): a comprehensive analysis by tumour site. Radiother Oncol 100(1):33–40CrossRef Blanchard P, Baujat B, Holostenco V, Bourredjem A, Baey C, Bourhis J et al (2011) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): a comprehensive analysis by tumour site. Radiother Oncol 100(1):33–40CrossRef
12.
go back to reference Pollom EL, Chin AL, Lee NY, Tsai CJ (2017) Patterns of Care in Adjuvant Therapy for Resected Oral Cavity Squamous Cell Cancer in Elderly Patients. Int J Radiat Oncol Biol Phys 98 (4):758–66CrossRefPubMedPubMedCentral Pollom EL, Chin AL, Lee NY, Tsai CJ (2017) Patterns of Care in Adjuvant Therapy for Resected Oral Cavity Squamous Cell Cancer in Elderly Patients. Int J Radiat Oncol Biol Phys 98 (4):758–66CrossRefPubMedPubMedCentral
13.
go back to reference Sommers LW, Steenbakkers RJHM, Bijl HP, Vemer-van den Hoek JGM, Roodenburg JLN, Oosting SF et al. (2017) Survival patterns in elderly head and neck squamous cell carcinoma patients treated with definitive radiation therapy. Int J Radiat Oncol Biol Phys 98 (4):793–801CrossRefPubMed Sommers LW, Steenbakkers RJHM, Bijl HP, Vemer-van den Hoek JGM, Roodenburg JLN, Oosting SF et al. (2017) Survival patterns in elderly head and neck squamous cell carcinoma patients treated with definitive radiation therapy. Int J Radiat Oncol Biol Phys 98 (4):793–801CrossRefPubMed
14.
go back to reference Kowalski LP, Alcantara PS, Magrin J, Parise Júnior O (1994) A case-control study on complications and survival in elderly patients undergoing major head and neck surgery. Am J Surg 168(5):485–490CrossRefPubMed Kowalski LP, Alcantara PS, Magrin J, Parise Júnior O (1994) A case-control study on complications and survival in elderly patients undergoing major head and neck surgery. Am J Surg 168(5):485–490CrossRefPubMed
15.
go back to reference Bernardi D, Barzan L, Franchin G (2005) Treatment of head and neck cancer in elderly patients: state of the art and guidelines. Crit Rev Oncol Hematol 53:71–80CrossRefPubMed Bernardi D, Barzan L, Franchin G (2005) Treatment of head and neck cancer in elderly patients: state of the art and guidelines. Crit Rev Oncol Hematol 53:71–80CrossRefPubMed
16.
go back to reference Zabrodsky M, Calabrese L, Tosoni A, Ansarin M, Giugliano G, Bruschini R et al (2004) Major surgery in elderly head and neck cancer patients: immediate and long-term surgical results and complication rates. Surg Oncol 13(4):249–255CrossRefPubMed Zabrodsky M, Calabrese L, Tosoni A, Ansarin M, Giugliano G, Bruschini R et al (2004) Major surgery in elderly head and neck cancer patients: immediate and long-term surgical results and complication rates. Surg Oncol 13(4):249–255CrossRefPubMed
17.
go back to reference Baijal P, Periyakoil V (2014 Oct) Understanding frailty in cancer patients. Cancer J Sudbury Mass 20(5):358–366CrossRef Baijal P, Periyakoil V (2014 Oct) Understanding frailty in cancer patients. Cancer J Sudbury Mass 20(5):358–366CrossRef
18.
go back to reference Huisman MG, Kok M, de Bock GH, van Leeuwen BL (2017) Delivering tailored surgery to older cancer patients: preoperative geriatric assessment domains and screening tools—a systematic review of systematic reviews. Eur J Surg Oncol 43(1):1–14CrossRefPubMed Huisman MG, Kok M, de Bock GH, van Leeuwen BL (2017) Delivering tailored surgery to older cancer patients: preoperative geriatric assessment domains and screening tools—a systematic review of systematic reviews. Eur J Surg Oncol 43(1):1–14CrossRefPubMed
19.
go back to reference Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146–M156CrossRef Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146–M156CrossRef
20.
go back to reference Singh B, Bhaya M, Stern J, Roland JT, Zimbler M, Rosenfeld RM et al (1997 Nov) Validation of the Charlson comorbidity index in patients with head and neck cancer: a multi-institutional study. Laryngoscope 107(11 Pt 1):1469–1475CrossRefPubMed Singh B, Bhaya M, Stern J, Roland JT, Zimbler M, Rosenfeld RM et al (1997 Nov) Validation of the Charlson comorbidity index in patients with head and neck cancer: a multi-institutional study. Laryngoscope 107(11 Pt 1):1469–1475CrossRefPubMed
21.
go back to reference Piccirillo JF, Spitznagel EL, Vermani N, Costas I, Schnitzler M (2004) Comparison of comorbidity indices for patients with head and neck cancer. Med Care 42(5):482–486CrossRefPubMed Piccirillo JF, Spitznagel EL, Vermani N, Costas I, Schnitzler M (2004) Comparison of comorbidity indices for patients with head and neck cancer. Med Care 42(5):482–486CrossRefPubMed
22.
go back to reference Neve M, Jameson MB, Govender S, Hartopeanu C (2016 Nov) Impact of geriatric assessment on the management of older adults with head and neck cancer: a pilot study. J Geriatr Oncol 7(6):457–462CrossRefPubMed Neve M, Jameson MB, Govender S, Hartopeanu C (2016 Nov) Impact of geriatric assessment on the management of older adults with head and neck cancer: a pilot study. J Geriatr Oncol 7(6):457–462CrossRefPubMed
23.
go back to reference Porceddu SV, Haddad RI. Management of elderly patients with locoregionally confined head and neck cancer. Lancet Oncol 2017 May 1;18(5):e274–83 Porceddu SV, Haddad RI. Management of elderly patients with locoregionally confined head and neck cancer. Lancet Oncol 2017 May 1;18(5):e274–83
24.
go back to reference Ghignone F, van Leeuwen BL, Montroni I, Huisman MG, Somasundar P, Cheung KL et al (2016) The assessment and management of older cancer patients: a SIOG surgical task force survey on surgeons’ attitudes. Eur J Surg Oncol 42(2):297–302CrossRefPubMed Ghignone F, van Leeuwen BL, Montroni I, Huisman MG, Somasundar P, Cheung KL et al (2016) The assessment and management of older cancer patients: a SIOG surgical task force survey on surgeons’ attitudes. Eur J Surg Oncol 42(2):297–302CrossRefPubMed
Metadata
Title
Impact of age on elderly patients with oral cancer
Authors
Akshat Malik
Aseem Mishra
Prashant Chopda
Hitesh Singhvi
Sudhir Nair
Deepa Nair
Sarbani Ghosh Laskar
Kumar Prabhash
Jai Prakash Agarwal
Pankaj Chaturvedi
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 1/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5191-1

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