Oral cavity squamous cell carcinoma in 260 patients aged 80 years or more

Cécile Ortholan, Antoine Lusinchi, Antoine Italiano, René Jean Bensadoun, Anne Auperin, Gilles Poissonnet, Alexandre Bozec, Rodrigo Arriagada, Stéphane Temam, Karen Benezery, Juliette Thariat, Yungan Tao, François Janot, Gérard Mamelle, Jacques Vallicioni, Philippe Follana, Frédéric Peyrade, Anne Sudaka, Jean Bourhis, Olivier Dassonville

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    Abstract

    Purpose: We report the experience of two French cancer centers in the treatment of oral cavity squamous cell carcinoma (SCC) in patients aged ≥80 years. Materials and methods: Two hundred and sixty patients aged ≥80 years with a primary oral cavity SCC were included in this retrospective analysis. Results: Sex ratio was near to 1. Tobacco or alcohol intoxication was the main risk factor for 66% of men and 16% of women and leukoplakia, lichen planus, or oral traumatism for 55% of women and 11% of men (p < 0.0001). Two hundred patients received a loco-regional (LR) treatment with a curative intent (surgery and/or radiotherapy), 29 with a palliative intent and 31 did not receive a LR treatment. Curative treatments were initially planned to be adapted to age in 118 patients (59%). The median disease-specific survival (DSS) was 29 months. In multivariate analysis, the independent prognostic factors for DSS were stage (HR = 0.42 [0.24-0.72]), age (HR = 0.43 [0.24-0.75]) and performance status (HR = 0.50 [0.27-0.95]). The median overall survival (OS) was 14 months. In multivariate analysis, the independent prognostic factors for OS were age (HR = 0.52 [0.35-0.79]), stage (HR = 0.56 [0.38-0.84]), tumor differentiation (HR = 0.60 [0.33-0.93]) and performance status (HR = 0.6 [0.37-0.97]). In patients treated with a curative intent, treatment adapted to age was not associated with a decreased overall survival or disease-specific survival as compared with the standard treatment. However, prophylactic lymph node treatment in stages I-II tumors decreased the rate of nodal recurrence from 38% to 6% (p = 0.01). Conclusion: This study emphasizes the need for prospective evaluation of standard and adapted schedules in elderly patients with oral cavity cancer.

    Original languageEnglish
    Pages (from-to)516-523
    Number of pages8
    JournalRadiotherapy and Oncology
    Volume93
    Issue number3
    DOIs
    Publication statusPublished - 1 Dec 2009

    Keywords

    • Elderly
    • Geriatric oncology
    • Oral cavity
    • Radiotherapy
    • Squamous cell carcinoma
    • Surgery

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