title: Human Papilloma Virus-positive Oropharyngeal Squamous Cell Carcinoma in the Elderly.
abstract: Elderly patients with HPV+ oropharyngeal cancer (OPC) represent an understudied cohort of the HPV epidemic. We aimed to investigate the clinical presentation, treatment tolerability and outcomes in patient's ≥65 years old with HPV+ OPC.
  
  
  
  We identified all patients aged 65 and older treated at our Institution with HPV+ OPC and analyzed patient demographics, disease characteristics, treatment modalities, toxicities, treatment failures, and survival. Charlson comorbidity index was calculated for each patient.
  
  
  
  43 patients were identified with a mean age of median age was 70.0 (range 65-86). The mean Charlson comorbidity index score for the cohort was 5.2. In total, 72.1% of patients received what was considered standard-of-care based on stage and pathological features. Nine point three percent of patients required RT-related treatment breaks with the majority being women (75%). Three-year actuarial overall survival was 85.5% (95% CI: 71.4%-100%) and 3-year disease-free survival was 67.3% (95% CI: 49.7-91.0%).
  
  
  
  This study presented one of the largest series to date evaluating HPV-related OPC in patients ≥65. Elderly individuals with HPV+ OPC have favorable overall survival with high treatment tolerability independent of Charlson co-morbidity score. Elderly patients should be considered for stage-appropriate care with omission of specific therapies based on absolute contraindications and patient preference, but not assumptions regarding tolerability.
authors.affiliation: Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: Eesha
authors.initials: E
authors.lastname: Dave
authors.affiliation: Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: William
authors.initials: W
authors.lastname: Su
authors.affiliation: Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: Vishal
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: Brett
authors.initials: B
authors.lastname: Miles
authors.affiliation: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Demicco
authors.affiliation: Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: Theresa
authors.initials: T
authors.lastname: Soriano
authors.affiliation: Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A. richard.bakst@mountsinai.org.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Bakst
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000821:virology*; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000821:virology*; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications* / Q000821:virology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
keywords: HPV; elderly; head & neck cancer