title: Matched analysis of survival in patients with squamous cell carcinoma of the head and neck diagnosed before and after 40 years of age.
abstract: OBJECTIVE
  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, disease-specific, 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 cancer-associated 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.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: Kristen B
authors.initials: KB
authors.lastname: Pytynia
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Grant
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Etzel
authors.forename: Dianna
authors.initials: D
authors.lastname: Roberts
authors.forename: Qingyi
authors.initials: Q
authors.lastname: Wei
authors.forename: Erich M
authors.initials: EM
authors.lastname: Sturgis
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate; D013781:Texas / Q000453:epidemiology