title: Outcome differences in younger and older patients with laryngeal cancer: a retrospective case-control study.
abstract: OBJECTIVE
  Younger or older age has a significant impact on the outcome of patients with head and neck cancer. However, the data regarding outcomes based on age are conflicting. The aim of this article is to determine the impact of age on the outcome of laryngeal cancer.
  
  
  METHODS
  A retrospective study was performed including all patients with squamous cell carcinoma of the larynx for over a 9-year period. The patients were divided into 3 groups based on age. The younger age group included patients 40 years of age and younger, the older group included patients over 80 years of age, and the remaining patients served as the control group. Descriptive statistics were used to summarize study data. Nonparametric quantitative and qualitative analyses were performed using the Mann-Whitney U test and Fisher's exact test, respectively. Survival analysis was performed using the generalized Wilcoxon test. The Cox proportional hazards model was used for multivariate analysis.
  
  
  RESULTS
  Of the 209 patients with laryngeal carcinoma presenting to our institution over a 9-year period, 20 (10%) were < or =40 years and 15 (7%) were > or =80 years of age. No differences in TNM stage at presentation, treatment, or treatment-associated complications were observed based on age. However, younger patients were less likely to report tobacco (50%; P < .001) or alcohol (57%; P = .03) use and more likely to have human immunodeficiency virus infection (50%; P< .001). Older patients showed a trend toward having a worse baseline medical status. Recurrence was significantly more common in older patients (P = .02) and cause-specific survival significantly poorer for both younger and older patients (P = .002).
  
  
  CONCLUSIONS
  The presentation and outcome of laryngeal cancer is influenced by the age at presentation. The differences may be related exact reason for the observed survival differences needs to be determined.
authors.affiliation: Department of Otolaryngology, State University of New York-Health Science Center at Brooklyn and The Long Island College Hospital, NY, USA.
authors.forename: B
authors.initials: B
authors.lastname: Singh
authors.forename: A
authors.initials: A
authors.lastname: Alfonso
authors.forename: S
authors.initials: S
authors.lastname: Sabin
authors.forename: A
authors.initials: A
authors.lastname: Poluri
authors.forename: A R
authors.initials: AR
authors.lastname: Shaha
authors.forename: K
authors.initials: K
authors.lastname: Sundaram
authors.forename: F E
authors.initials: FE
authors.lastname: Lucente
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome