Impact of age and comorbidity on survival among patients with oral cavity squamous cell carcinoma

Head Neck. 2021 Jan;43(1):268-277. doi: 10.1002/hed.26487. Epub 2020 Sep 30.

Abstract

Objective: To identify predictors of overall survival (OS) and to stratify patients according to significant prognostic variables.

Methods: A retrospective study of 274 consecutive patients with primary Oral Cavity Squamous Cell Carcinoma. Kaplan-Meier, Cox proportional hazard models, and recursive partitioning analysis (RPA) were used for analysis of OS. These results were further validated using National Cancer Database cohort of 21 895 patients.

Results: Median OS was 3.65 years. T-classification and N-classification, alcoholic beverages/week, age, and adjuvant treatment were significant predictors of OS. RPA identified high-risk subpopulations: N0-1 patients with CCI ≥ 4.5 and N2-3 patients ordered by those not receiving adjuvant treatment, those with T3-4 disease despite adjuvant therapy, and those having T1-2 disease with adjuvant therapy.

Conclusions: This study utilized significant prognostic indicators and RPA to highlight the importance of age, N-classification, T-classification, comorbidity, and adjuvant therapy in conjunction with American Joint Committee on Cancer staging to improve preoperative counseling.

Keywords: NCDB; National Cancer Database; comorbidity; head and neck cancer; oral cavity cancer; overall survival; squamous cell carcinoma; staging.

MeSH terms

  • Carcinoma, Squamous Cell* / epidemiology
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / therapy
  • Comorbidity
  • Head and Neck Neoplasms*
  • Humans
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck