Treatment strategies for and outcomes of older patients with oral squamous cell carcinoma

Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Apr;129(4):322-329. doi: 10.1016/j.oooo.2019.10.009. Epub 2020 Feb 24.

Abstract

Objective: The purpose of this study was to investigate factors that have a significant impact on decision making regarding treatment strategies and on the resultant outcomes in older patients with oral squamous cell carcinoma (OSCC).

Study design: To define fit, vulnerable, and frail patients, as well as treatment strategies/outcomes, in patients 75 years of age and older with primary OSCC were retrospectively reviewed from the medical records.

Results: Among patients with stage I and II tumors, those with a Geriatric 8 (G8) score of 11.5 or greater had favorable outcomes and those with a score less than 11.5 had acceptable outcomes (5-year self-reliance [SR] rates: 80.8 and 53.5%, respectively). Among patients with stage III and IV tumors, those with the Eastern Cooperative Oncology Group-Performance status (ECOG-PS) score less than 2 and/or a G8 score 11.5 or greater mainly received standard therapy, had favorable outcomes (5-year SR rate: 66.7%). The 5-year SR rates of stage IV patients with an ECOG-PS score 2 or greater and those with a G8 score less than 11.5 were poor regardless of any treatment strategy. Although the 5-year SR rate of patients with standard therapy was 73.4%, that of patients receiving other curative therapies was 0%.

Conclusions: In patients with stage III/IV, ECOG-PS 2 or greater, and/or G8 score less than 11.5, treatment was difficult, and the prognosis was poor.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell*
  • Humans
  • Mouth Neoplasms*
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome