Head and Neck Squamous Cell Carcinoma in Elderly Patients

Sarini, J.; Fournier, Charles; Lefebvre, Jean‐Louis; Bonafos, Guillaume; Van, J. Ton; Coche‐Dequeant, B.

doi:10.1001/archotol.127.9.1089

Cited by 121 publications

(101 citation statements)

References 12 publications

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“…In contrast to some reports [9][10][11], it was our observation, as well as that of others [12,13] that the older patients in general had less advanced disease. This distribution of stage in favour of the older patients was accentuated after exclusion of the early stage glottic carcinomas.…”

Section: Discussioncontrasting

confidence: 99%

“…Although the group of patients older than 65 had the poorest survival rate, the fact that 40% of the patients older than 65 were alive and free of disease at the closure of this study, strongly suggests that treatment is worthwhile in patients at an advanced age, regarding the disease-free survival for SCCHN. This observation concurs with observations in materials similar to the present study [1,13]. Other reports further substantiate the opinion that age in itself is not an independent prognostic factor, neither is it in itself a decisive factor for survival of SCCHN [9,11,[15][16][17].…”

Section: Discussionsupporting

confidence: 93%

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Squamous Cell Carcinoma of the Head and Neck in the Elderly

Boysen¹

2009

TOOTORJ

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Abstract:Background: Increasing life expectancy and incidence of head and neck carcinomas, including some types of head and neck malignancies, lead to a constantly higher proportion of old oncologic patients. Previous reports regarding the outcome for elderly patients with head and neck carcinomas squamous cell carcinoma (HNSCC) are controversial. For further insight, a large single-institution material has been analysed.Material: Prospective recording of demographic details, continuous follow-up and determining exact cause of deaths of patients with carcinoma of the head and neck have been in progress over a period of 14 years. Having excluded 154 patients (7.3%), who did not follow-up, who had distant metastases at diagnosis, or who had received extensive treatment for a previous head and neck carcinoma or who refused treatment, or for medical or mental reasons, were unable to receive curative treatments. The material includes 1944 patients, of whom 37% received combined treatment, 58% radiotherapy alone and 6% surgery alone. The mean age was 65 years with a mean follow-up of 3.8 years. The material was divided into two groups; 65 and >65 years of age and analysed by means of X 2 tests and log-rank X 2 tests.Results: Early stage primary tumours and a more advantageous N-classification were more conspicuous among the older patients (p = 0.2406 and p<0.0002). The group of patients 65 years had a significantly better disease-specific survival rate compared to the older patients (p = 0.145). However, 40 % of the older patients were alive with no evidence of disease. By comparing 65-74 patients with patients' 76 years of age, a p-value of 0.0105 was obtained in favour of the younger group, but still an appreciable number of the older patients escaped their HNSCC. Conclusion:Given a satisfactory mental and physical condition, patients older than 65 years had a reasonable diseasespecific survival. It is therefore no reason to withhold appropriate treatment for the elderly, fit patients which could prevent or delay the misery and devastating situation, as well as a reduction in the heavy expenditures that patients with persistent or recurrent head and neck tumours represent.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 93%

Squamous Cell Carcinoma of the Head and Neck in the Elderly

Boysen¹

2009

TOOTORJ

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“…No entanto, apesar de vários autores optarem por valores mais amplos, foi utilizado o critério da Organização Mundial da Saúde (OMS), que indica a idade de 60 anos como início da terceira idade nos países em desenvolvimento (42) . Ao contrário de outro estudo (37) , foi encontrado um comportamento diferente entre os grupos de idade, mostrando diferenças significativas nas curvas de sobrevivência, sugerindo que a diminuição da sobrevida nos mais idosos pode ocorrer devido à maior incidência de doenças debilitantes, maiores seqüelas pós-tratamento e complicações associadas ao envelhecimento.…”

Section: Discussionunclassified

Perfil da incidência e da sobrevida de pacientes com carcinoma epidermóide oral em uma população brasileira

Oliveira¹,

Ribeiro‐Silva²,

Zucoloto³

2006

J. Bras. Patol. Med. Lab.

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unitermos key words resumoIntrodução: A incidência do câncer bucal no Brasil é uma das mais altas do mundo. Objetivos: Avaliar o perfil, os fatores de risco e a sobrevida de pacientes diagnosticados com carcinoma epidermóide oral entre 1982 e 2002 em uma população brasileira. Material e método: Idade, gênero, local da lesão, história pregressa, consumo de tabaco e bebidas alcoólicas, exposição actínica, traumatismo por prótese, recidivas, metástases e sobrevida foram obtidos dos prontuários. Resultados: Dos 340 pacientes 84,4% eram homens e 15,6%, mulheres (5,4:1). As lesões linguais foram as mais freqüentes (27,9%). Vinte por cento dos pacientes relataram traumatismo por prótese e em 73,8% das lesões em lábio inferior foi relatada exposição actínica desprotegida. Não houve diferença entre as regiões anatômicas e o consumo de tabaco em relação a recidivas, metástases regionais e metástases à distância. O tempo médio de história pregressa foi de 13 meses, havendo diferença entre as regiões anatômicas. A sobrevida em cinco anos foi de 24%. A sobrevida dos pacientes com recidivas e/ou metástases variou conforme a idade analisada ( 60 ou > 60 anos), mas não houve diferença quanto à história pregressa e às regiões anatômicas. A discrepância homem/mulher encontrada foi alta, diminuindo conforme o aumento da idade. O consumo de tabaco e álcool é elevado nessa população, mas não influenciou as recidivas e as metástases da doença. Foi grande o tempo de evolução das lesões até a procura pelo serviço. Conclusões: Os baixos índices de sobrevida refletem a necessidade de uma maior atenção ao câncer bucal nessa população.

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“…It was also stressed that elderly patients cannot be excluded from chemoradiotherapy programs of organ preservation and patients aged 70 Á79 without severe comorbidities must be treated in the same exact manner as younger patients, but supportive treatment must be increased. In a retrospective review of 273 cases on head and neck cancers in elderly patients it was concluded that when properly monitored, conventional therapies seem feasible in older patients [17]. Same results have been achieved from studies on treatment of gastrointestinal cancers.…”

Section: Discussionmentioning

confidence: 99%