Outcomes of curative treatment for head and neck squamous cell carcinoma in very elderly adults ≥80 years old

Head Neck. 2022 Nov;44(11):2370-2377. doi: 10.1002/hed.27141. Epub 2022 Jul 13.

Abstract

Background: Head and neck cancer treatment can be difficult and advancing age is associated with greater frailty. It is unclear if curative treatment for very elderly patients is beneficial. This study compared outcomes to curative treatment in patients ≥80 aged with HNSCC to patients aged 70-79.

Methods: Retrospective study of 114 patients diagnosed with HNSCC. Overall survival (OS), Disease-Free Survival (DFS), and local-regional control (LRC) were compared and adjusted for confounders.

Results: Patients aged 70-79 had a higher median OS (35 months [95% CI, 19.58-50.42]) compared with patients aged ≥80 (19 months [11.72-26.28]; p = 0.008) but similar DFS and LRC. KPS < 90 was the stand-alone independent prognostic factor for OS (HR = 2.14 [1.05-4.38]).

Conclusion: Very elderly HNSCC patients (aged ≥80) can have favorable outcomes with curative therapy and advanced chronological age alone should not prohibit patients from receiving treatment. Performance status may be a greater predictor of survival outcome than age alone.

Level of evidence: Level III.

Keywords: cancer; elderly; squamous cell carcinoma; survival; treatment.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell* / pathology
  • Disease-Free Survival
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / therapy