Background: Head and neck squamous cell carcinoma (HNSCC) is increasing in prevalence as society ages worldwide. However, there are no established treatment protocols for elderly patients, and the threshold for defining "elderly" is undetermined. In this study, we categorized elderly patients (65 years and older) with HNSCC into 2 groups: "young-old," from 65 to 74 years old, and "old-old," 75 years and older, and compared their treatment outcomes.
Methods: The subjects were 182 patients aged 65 years and older who visited our hospital for HNSCC from 2003 to 2009. We categorized them into 2 groups, young-old (65-74 years) and old-old (75 years and older), and compared the male-female ratio, ratio with underlying diseases, primary tumor sites, disease stage, applied treatments and curative rate. Additionally, for the curative treatment category in both groups, we compared recurrence rate, relationship between recurrence rate and use of concomitant chemotherapy, the 5-year relapse-free survival and the 5-year cause-specific survival.
Results: The ratio of patients with underlying diseases in the old-old group was significantly higher than in the young-old group, but there was no significant difference in curative rate between the 2 (old-old, 81.9%; young-old, 82.7%). The 5-year, cause-specific survival in curative treatment category was significantly lower in the old-old (66.1%) group than the young-old (94.1%) group.
Conclusion: Elderly patients of all ages should positively receive curative treatment. We suppose that concomitant chemotherapy is not acceptable in elderly patients. The 5-CSS of the curative treatment category in the old-old patients was significantly lower than in the young-old patients.
Keywords: elderly patients; head and neck squamous cell carcinoma; outcome.