Factors Influencing Treatment Outcome of Non-Nasopharyngeal Head and Neck Squamous Cell Carcinoma in Geriatric Patients

Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) are a heterogeneous group of malignancy. Their incidenceincreases with age. Therefore, elderly HNSCC patients represent a large population who need special care and treatment considerations. Aim of work:To correlate clinicopathologic factors of nonnasopharyngeal HNSCC geriatric patients with disease free survival (DFS) and overall survival (OS). Patients and methods:A retrospective analysis of fifty nonnasopharyngeal HNSCC elderly patients (≥ 65 years) treated at the head and neck cancer unit at the clinical oncology department, Ain Shams University Hospitals from June 2014 to June 2019. The study correlatedpatients' age, comorbidities, tumor stage and Eastern Cooperative Oncology Group performance state (ECOG PS) with disease free survival (DFS) and overall survival (OS). Results:Three years DFS rate among the patients aged 65-75 years was 73% versus 40% among patients aged 76-80 years and three years OS rate decreased from 48.2% to 40% respectively. The median OS was 39.5 months for patients without co-morbidities compared to 32.5 months for patients with associated co-morbidities (P=0.9) and the median DFS was nearly about 40 months for both groups (p=0.7).Three years DFS was 78.7% among the patients with PS I and 54% among PS II and III (P=0.56) while three years OS rate was 60.7% among patients with PS I but it was 42% for PS II and III (p=0.5). The mean DFS dropped from 43.9 months to 18.4 months for early stages and locally advanced respectively but with no statistical significance association (P=0.49). There was marked decrease of 2years OS from 100% for early stages to 40.3% for locally advanced stages (p=0.009). Conclusion: In HNSCC geriatric patients age >75 years and locally advanced stages were poor prognostic factors for DFS and OS while co-morbidities and ECOG PS didn't affect treatment outcome.