Clinical characteristics, treatment methods and prognoses of patients with oral squamous cell carcinoma in Japanese population: a single institution retrospective cohort study

Abstract

Background The status of oral cancer therapy in elderly patients in Japan, where ageing is rapidly progressing, may serve as a model for other countries with similar demographics. There is controversy over what kind of treatment should be applied and how aggressively it should be applied to very elderly patients who have exceeded the average life expectancy. Given that 85 years is approximately the overall Japanese life expectancy at birth, we considered a threshold of 85 years and hypothesized that the prognosis of oral squamous cell carcinoma (SCC) patients aged ≥85 years was not inferior to that of those < 85 years. The aim of the present study was to investigate the clinical characteristics, treatment methods, and prognoses of Japanese oral SCC patients aged ≥85 years. Methods A retrospective cohort study was performed. The data of patients with primary oral SCC (n = 358) from 2005 to 2018 in our institute were extracted from electronic medical records. A total of 358 patients with oral SCC were divided into two groups (≥85 years group [n = 26] and < 85 years group [n = 332]) based on the age threshold of 85 years at the first visit. Kaplan-Meier survival analyses and Cox proportional hazard models were used to analyse overall survival (OS) and hazard ratios (HRs) according to age group, treatment, and TNM classification. Results There was no difference in the 5-year OS rate between the ≥85 years and < 85 years groups (80.8% vs. 82.2%, P = 0.359). This finding was the same in the operative (94.7% vs. 85.8%, P = 0.556) and non-operative (42.9% vs. 33.2%, P = 0.762) groups, indicating that age did not affect prognosis. Mortality was lower in the operative group than in the non-operative group (adjusted HR: 0.276, 95% CI: 0.156–0.489, P < 0.001), suggesting that surgery is a superior method. However, non-surgical treatment was selected at a higher rate in the ≥85 years group (26.9% vs. 11.1%, P = 0.028). Conclusions This study suggests the prognosis of ≥85-year-old patients was not inferior to that of < 85-year-old patients. We recommend that surgery as the first choice treatment for ≥85-year-old patients with oral SCC who can tolerate surgery should be performed.

Epidemiology and survival outcomes of lip, oral cavity, and oropharyngeal squamous cell carcinoma in a southeast Brazilian population

“…Likewise, in our sample, 72% of lip SCC cases were treated with surgery alone. Although most cases were in the advanced stage, surgery alone was the most frequently employed treatment for OSCC cases in our sample, which corroborates previous reports ( 8 , 16 , 26 ). Nevertheless, in the studies performed by Asio et al .…”

“…Lip SCC and OSCC mainly occurred in older people. The average age at the time of diagnosis was approximately 65 ± 13.5 years and 60.3 ± 12.1 years in the present study, respectively, which corroborates previous studies performed in Italy ( 10 ), Mexico ( 14 ), and the United States (US) ( 15 ) for lip SCC and Brazil ( 8 ), Japan ( 16 ), and Australia ( 17 ) for OSCC. In contrast, the mean age at diagnosis was lowest for OPSCC (58.6 ± 10 years), with the prevalence peaking in the sixth decade of life.…”

“…Patients treated with surgery alone presented higher survival rates compared to patients treated with combinations of RT and CT. Fukumoto et al . ( 16 ), Bai et al . ( 7 ), and Farhood et al .…”

Identification of Binding Proteins for TSC22D1 Family Proteins Using Mass Spectrometry

“…Many cancers including head and neck cancer have been treated by molecular-targeted drugs in addition to surgery, chemotherapy, and radiotherapy [1,2]. Acute promyelocytic leukemia can be treated by all-trans retinoic acid (ATRA), which is a molecular-targeted drug and has a differentiation-inducing activity [3,4].…”

Paclitaxel Potentiates the Anticancer Effect of Cetuximab by Enhancing Antibody-Dependent Cellular Cytotoxicity on Oral Squamous Cell Carcinoma Cells In Vitro

“…With these treatments, overall survival (OS) and progression-free survival (PFS) in patients with oral SCC have improved considerably. In the department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine, favorable therapeutic results have been obtained over the fourteen-year period from 2005 to 2018, as shown by the five-year OS rates of 87.5% for Stage I, 88.8% for Stage II, 80.9% for Stage III, and 62.5% for Stage IV, respectively [ 4 ]. However, some patients have shown local recurrence, cervical lymph node metastasis, and distal metastasis after the initial treatments, and it is difficult to achieve a complete cure for such patients.…”