Oral cavity squamous cell carcinoma in 260 patients aged 80years or more.
OBJECTIVE
We report the experience of two French cancer centers in the treatment of oral cavity squamous cell carcinoma (SCC) in patients aged 80 years.


METHODS
Two hundred and sixty patients aged 80 years with a primary oral cavity SCC were included in this retrospective analysis.


RESULTS
Sex ratio was near to 1. Tobacco or alcohol intoxication was the main risk factor for 66% of men and 16% of women and leukoplakia, lichen planus, or oral traumatism for 55% of women and 11% of men (p<0.0001). Two hundred patients received a loco-regional (LR) treatment with a curative intent (surgery and/or radiotherapy), 29 with a palliative intent and 31 did not receive a LR treatment. Curative treatments were initially planned to be adapted to age in 118 patients (59%). The median disease-specific survival (DSS) was 29 months. In multivariate analysis, the independent prognostic factors for DSS were stage (HR=0.42 [0.24-0.72]), age (HR=0.43 [0.24-0.75]) and performance status (HR=0.50 [0.27-0.95]). The median overall survival (OS) was 14 months. In multivariate analysis, the independent prognostic factors for OS were age (HR=0.52 [0.35-0.79]), stage (HR=0.56 [0.38-0.84]), tumor differentiation (HR=0.60 [0.33-0.93]) and performance status (HR=0.6 [0.37-0.97]). In patients treated with a curative intent, treatment adapted to age was not associated with a decreased overall survival or disease-specific survival as compared with the standard treatment. However, prophylactic lymph node treatment in stages I-II tumors decreased the rate of nodal recurrence from 38% to 6% (p=0.01).


CONCLUSIONS
This study emphasizes the need for prospective evaluation of standard and adapted schedules in elderly patients with oral cavity cancer.
Ortholan
Cécile
C
Department of Radiotherapy, Centre Antoine-Lacassagne, Nice, France. c.ortholan@wanadoo.fr
Lusinchi
Antoine
A
Italiano
Antoine
A
Bensadoun
René-Jean
RJ
Auperin
Anne
A
Poissonnet
Gilles
G
Bozec
Alexandre
A
Arriagada
Rodrigo
R
Temam
Stéphane
S
Benezery
Karen
K
Thariat
Juliette
J
Tao
Yungan
Y
Janot
François
F
Mamelle
Gérard
G
Vallicioni
Jacques
J
Follana
Philippe
P
Peyrade
Frédéric
F
Sudaka
Anne
A
Bourhis
Jean
J
Dassonville
Olivier
O
D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009062:Mouth Neoplasms / Q000209:etiology / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D010166:Palliative Care; D012307:Risk Factors; D015996:Survival Rate