Matched Analysis of Survival in Patients With Squamous Cell Carcinoma of the Head and Neck Diagnosed Before and After 40 Years of Age

Abstract

To compare the survival rates of patients 40 years or younger and diagnosed with squamous cell carcinoma of the head and neck (SCCHN) with those of patients older than 40 years who underwent the same treatment. In 2 previous matched-pair analyses, the patients had been matched for tumor stage, site, sex, and date of presentation but not type of treatment. Methods: Between 1995 and 2001, 46 patients 40 years or younger participated in a prospective epidemiologic study that included more than 500 patients newly diagnosed with SCCHN. We matched each of these patients by sex, race, tumor site, overall stage, and treatment modality with 2 patients older than 40 years. Ultimately, 31 of the younger patients were matched with 62 of the older patients. Survival analysis was performed using Cox proportional hazard models and accounting for the matched trios. Results: There was no difference in overall, diseasespecific, or recurrence-free survival rates between the patients who were 40 years or younger and those older than 40 years. Furthermore, matched survival analysis did not demonstrate a difference in overall survival rate (risk ratio [RR], 0.71; 95% confidence interval [CI], 0.22-2.29; P=.56), disease-free survival rate (RR, 0.83; 95% CI, 0.20-3.33; P =.79), or time to recurrence (RR, 1.46; 95% CI, 0.50-4.23; P =.49), and was not affected by adjustment for medical comorbidities or the severity of cancerassociated symptoms. Conclusions: We found no evidence of a difference in the survival rates of patients with SCCHN who were 40 years or younger or older than 40 years and underwent similar treatment at our institution.

Analysis of prognostic factors through survival rate analysis of oral squamous cell carcinoma patients treated at the National Cancer Center: 20 years of experience

“…Research on similar age groups demonstrated that the survival rate (61%-72.7%) in older patients was higher than that in young patients (55%-66.6%) 14 - 16 . In contrast with our data, Pytynia et al 17 , Ho et al 18 , and Udeabor et al 19 reported higher survival rates in young patients. Further research is required considering the inconsistent data on survival rates according to sex and age.…”

Squamous Cell Carcinoma of the Head and Neck in the Elderly

“…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.…”

“…Contrary to others [10,11] this study showed the highest incidence of secondary malignancies of the aero-digestive tract among the group with the older patients. This may, to some extent, be an effect of insufficient observation time.…”

“…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]. On the other hand, Davidson and co-workers [18] showed in a material of oral tongue squamous cell carcinoma matched for age, gender, site, stage and treatment that an increase of 10 years in age was associated with an 18% increase in diseasespecific mortality.…”

Factors that Influence 2-Year Progression-Free Survival Among Head and Neck Cancer Patients

“…We did not found that age affects PFS (RR 0.90; 95% CI 0.64-1.25; p = 0.52). This result was consistent with previous studies from Pytynia et al [20] and Fisher et al [21]. A reasonable explanation for this was because most patients had no comorbidities and good performance status regardless of their age.…”