The Association between Patient's Age and Head and Neck Cancer Treatment Decision-A Population-Based Diagnoses-Related Group-Based Nationwide Study in Germany

Mussab Kouka; Isabel Hermanns; Peter Schlattmann; Orlando Guntinas-Lichius

doi:10.3390/cancers15061780

The Association between Patient's Age and Head and Neck Cancer Treatment Decision-A Population-Based Diagnoses-Related Group-Based Nationwide Study in Germany

Cancers (Basel). 2023 Mar 15;15(6):1780. doi: 10.3390/cancers15061780.

Authors

Mussab Kouka¹, Isabel Hermanns¹, Peter Schlattmann², Orlando Guntinas-Lichius¹

Affiliations

¹ Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany.
² Department of Medical Statistics, Computer Sciences and Data Sciences, Jena University Hospital, 07743 Jena, Germany.

Abstract

Investigations on the association between patient's age and head and neck cancer (HNC) treatment decision are sparse. Nationwide diagnoses-related group-based data of 1,226,357 cases hospitalized with primary HNC in Germany from 2005 to 2018 were included. Negative binomial regression was performed to study the development of the treatment rates over time. For all treatment options, i.e., biopsies, surgery, radiotherapy, and chemotherapy/biologicals, increases in the treatment rates were seen in patients >80 years (surgery: oral cavity: relative risk [RR]: 1.2, CI: 1.13-1.20; oropharynx: RR: 1.2, CI: 1.15-1.34; hypopharynx: RR: 1.1, CI: 1.02-1.17; larynx: RR: 1.1, CI: 1.04-1.12; radiotherapy: oral cavity: RR: 1.1, CI: 1.07-1.23; oropharynx: RR: 1.3, CI: 1.16-1.49; hypopharynx: RR: 1.3, CI: 1.21-1.46; larynx: RR 1.2, CI: 1.03-1.29; chemotherapy: oral cavity: RR: 1.2, CI: 1.06-1.31; salivary glands: RR: 1.3, CI: 1.09-1.50; oropharynx: RR: 1.4, CI: 1.12-1.83; hypopharynx: RR: 1.3, CI: 1.06-1.48; larynx: RR: 1.3, CI: 1.08-1.52, all p < 0.05). Older age cohorts (≥80 years) need more awareness as they are mainly responsible for the increase in the rates of surgery, radiotherapy, and chemotherapy/biologics in HNC patients.

Keywords: age; diagnoses-related-group-based; head and neck cancer; retrospective analysis; treatment rate.

Grants and funding

We acknowledge support by the German Research Foundation Projekt-Nr. 512648189 and the Open Access Publication Fund of the Thueringer Universitaets- und Landesbibliothek Jena.