title: Age and stage as determinants of treatment for oral cavity and oropharyngeal cancers in the elderly.
abstract: BACKGROUND
  We investigate treatment selection for oral cavity and oropharyngeal (OC&OP) cancers to understand factors that influence treatment selection.
  
  
  METHODS
  We studied 7023 patients, ⩾66 years, diagnosed with a first primary OC&OP cancer using SEER-Medicare data. Multinomial logistic regression was to model treatment selection, controlling for other factors.
  
  
  RESULTS
  Most patients with OC cancer were treated with surgery alone (56.5%); most patients with OP cancer were treated with chemotherapy and radiation (28.9%). Age, stage and site were the most important predictors of treatment selection. As age increased from 70 to 81 (the interquartile range), treatment shifted toward surgery alone (OR=1.26; CI: 1.08-1.46) and no treatment (OR=1.5, 95% CI: 1.25-1.80), and away from combined surgery, radiation and treatments involving chemotherapy.
  
  
  CONCLUSIONS
  Age, stage, and site are the most important determinants of treatment selection for patients with OC&OP cancers. Increasing age and stage drive treatment toward non-surgical options and no treatment at all.
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, United States. Electronic address: dgoldenberg@hmc.psu.edu.
authors.forename: David
authors.initials: D
authors.lastname: Goldenberg
authors.affiliation: Department of Radiology, The Pennsylvania State University, College of Medicine, Hershey, PA, United States.
authors.forename: Heath
authors.initials: H
authors.lastname: Mackley
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University, Baltimore, MD, United States.
authors.forename: Wayne
authors.initials: W
authors.lastname: Koch
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, United States.
authors.forename: Darrin V
authors.initials: DV
authors.lastname: Bann
authors.affiliation: Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, United States.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Schaefer
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, United States; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, United States.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hollenbeak
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009062:Mouth Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Elderly age; Head and neck cancer; Oral cancer; Oropharyngeal cancer; Radiation chemotherapy; Surgery