Head and neck squamous cell carcinoma in patients aged > or = 80 years: patterns of care and survival.

Abstract

Scarce data exist concerning the outcome of very elderly patients with head and neck squamous cell carcinoma (HNSCC). The clinical files of 316 patients aged > or = 80 years with HNSCC who were included in the authors' hospital database between 1987 and 2006 were reviewed retrospectively. Approximately 88% of patients received locoregional treatment, 31% of patients underwent surgery, and 57% of patients received definitive radiotherapy. The median disease-specific survival (DSS) was 21.3 months, and a plateau was observed after 5 years. The median overall survival (OS) was 13.0 months. Both the median DSS and the median OS were longer for patients with stage I/II HNSCC than for patients with stage III/IV HNSCC (median DSS, not reached vs 11.4 months; P < .001; median OS, 41.9 months vs 7.9 months; P < .001). On multivariate analysis, stage I/II disease, treatment with curative intent, and evidence of locoregional control were independent predictors of improved survival. The outcome of patients with stage I/II HNSCC aged > or = 80 years was similar to that of younger patients, and the current results indicated that age should not be used to deny them optimal treatment. Elderly patients with stage III/IV HNSCC had poor survival. Geriatric tools should be used to identify elderly patients who are eligible for optimal locoregional treatment.