Perioperative survival of elderly head and neck squamous cell carcinoma patients.
OBJECTIVE
To evaluate the survival benefit of surgery for elderly head and neck cancer (HNC) patients.


METHODS
Retrospective national database cohort study of HNC patients.


METHODS
The study is a retrospective cohort review of the Surveillance, Epidemiology, and End-Results (SEER) database from 2004 to 2009. We developed an estimated perioperative window, based on the institutional database at a tertiary academic center. The average time to surgery among HNC patients at this center correlated with SEER's 3-month post diagnosis. From this estimate, we calculated postoperative (3 months), 2-year, and 5-year overall survival (OS) for patients receiving HNC surgery from 2004 to 2009 in the SEER database. Patients were matched for sex, tumor grade/stage, primary location, and radiation treatment status.


RESULTS
Overall, after matching we found a statistically significant decrease in 3-month OS for the elderly patients versus younger controls who received surgery (P < .05). However, a matched analysis of elderly patients alone found a significant increase in OS for elderly patients who received surgery compared to those who did not (P < .05).


CONCLUSIONS
Surgery appears to offer overall benefit to elderly HNC patients. These patients have a significantly worse postoperative OS than their younger counterparts, but the clinical significance appears to be limited. The improved survival among elderly patients who receive surgery compared to those who do not suggests that surgery should be offered to properly selected patients regardless of age.
College of Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
William A
WA
Stokes
Collin
C
Fuller
Terry A
TA
Day
Marion B
MB
Gillespie
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D059035:Perioperative Period; D012189:Retrospective Studies; D018426:SEER Program; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Aged; elderly; head and neck neoplasms; larynx; oral cavity; oropharynx; perioperative survival; squamous cell carcinoma