Outcomes for Elderly Patients Aged 70 to 80 Years or Older with Locally Advanced Oral Cavity Squamous Cell Carcinoma: A Propensity Score–Matched, Nationwide, Oldest Old Patient–Based Cohort Study
<i>Purpose</i>: Although clinicians encounter patients aged ≥70 years with locally advanced oral cavity squamous cell carcinoma (LA-OCSCC), no evidence is available to facilitate decision making regarding treatment for this elderly population. <i>Methods</i>: We sel...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-01-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/2/258 |
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| author | Ben-Chang Shia Lei Qin Kuan-Chou Lin Chih-Yuan Fang Lo-Lin Tsai Yi-Wei Kao Szu-Yuan Wu |
| author_facet | Ben-Chang Shia Lei Qin Kuan-Chou Lin Chih-Yuan Fang Lo-Lin Tsai Yi-Wei Kao Szu-Yuan Wu |
| author_sort | Ben-Chang Shia |
| collection | DOAJ |
| description | <i>Purpose</i>: Although clinicians encounter patients aged ≥70 years with locally advanced oral cavity squamous cell carcinoma (LA-OCSCC), no evidence is available to facilitate decision making regarding treatment for this elderly population. <i>Methods</i>: We selected elderly (≥70 years) patients from the Taiwan Cancer Registry database who had received a diagnosis of LA-OCSCC. Propensity score matching was performed. Cox proportional hazards model curves were used to analyze all-cause mortality in patients in different age groups receiving different treatments. <i>Results</i>: The matching process yielded a final cohort of 976 patients in concurrent chemoradiotherapy (CCRT), non-treatment, radiotherapy (RT) alone, and surgery cohorts who were eligible for further analysis. After stratified analysis, the adjusted hazard ratios (aHRs) (95% confidence intervals [CIs]) derived for surgery, RT alone, and non-treatment compared with CCRT were 0.66 (0.52 to 0.83), 1.02 (0.81 to 1.28), and 1.52 (1.21 to 1.91), respectively, in patients aged 70 to 80 years. In the oldest patients (aged >80 years), multivariate analysis indicated that the results of surgery or RT alone were nonsignificant compared with those of CCRT. The aHR (95% CI) derived for the highest mortality was 1.81 (1.11 to 2.40) for non-treatment compared with CCRT. <i>Conclusions</i>: Surgery for elderly patients with LA-OCSCC is associated with a significant survival benefit, but the association is nonsignificant in the oldest elderly patients. No survival differences were observed between RT alone and CCRT in these elderly patients. Non-treatment should not be an option for these patients. |
| first_indexed | 2024-03-12T10:54:20Z |
| format | Article |
| id | doaj.art-42740eb0af294d4f933b1200d2a5aef6 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T10:54:20Z |
| publishDate | 2020-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-42740eb0af294d4f933b1200d2a5aef62023-09-02T06:36:09ZengMDPI AGCancers2072-66942020-01-0112225810.3390/cancers12020258cancers12020258Outcomes for Elderly Patients Aged 70 to 80 Years or Older with Locally Advanced Oral Cavity Squamous Cell Carcinoma: A Propensity Score–Matched, Nationwide, Oldest Old Patient–Based Cohort StudyBen-Chang Shia0Lei Qin1Kuan-Chou Lin2Chih-Yuan Fang3Lo-Lin Tsai4Yi-Wei Kao5Szu-Yuan Wu6Research Center of Big Data, College of management, Taipei Medical University, Taipei 110, TaiwanSchool of Statistics, University of International Business and Economics, Beijing 100029, ChinaDivision of Oral and Maxillofacial surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei 110, TaiwanDivision of Oral and Maxillofacial surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei 110, TaiwanDivision of Oral and Maxillofacial surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei 110, TaiwanGraduate Institute of Business Administration, Fu Jen Catholic University, Taipei 242, TaiwanDepartment of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan<i>Purpose</i>: Although clinicians encounter patients aged ≥70 years with locally advanced oral cavity squamous cell carcinoma (LA-OCSCC), no evidence is available to facilitate decision making regarding treatment for this elderly population. <i>Methods</i>: We selected elderly (≥70 years) patients from the Taiwan Cancer Registry database who had received a diagnosis of LA-OCSCC. Propensity score matching was performed. Cox proportional hazards model curves were used to analyze all-cause mortality in patients in different age groups receiving different treatments. <i>Results</i>: The matching process yielded a final cohort of 976 patients in concurrent chemoradiotherapy (CCRT), non-treatment, radiotherapy (RT) alone, and surgery cohorts who were eligible for further analysis. After stratified analysis, the adjusted hazard ratios (aHRs) (95% confidence intervals [CIs]) derived for surgery, RT alone, and non-treatment compared with CCRT were 0.66 (0.52 to 0.83), 1.02 (0.81 to 1.28), and 1.52 (1.21 to 1.91), respectively, in patients aged 70 to 80 years. In the oldest patients (aged >80 years), multivariate analysis indicated that the results of surgery or RT alone were nonsignificant compared with those of CCRT. The aHR (95% CI) derived for the highest mortality was 1.81 (1.11 to 2.40) for non-treatment compared with CCRT. <i>Conclusions</i>: Surgery for elderly patients with LA-OCSCC is associated with a significant survival benefit, but the association is nonsignificant in the oldest elderly patients. No survival differences were observed between RT alone and CCRT in these elderly patients. Non-treatment should not be an option for these patients.https://www.mdpi.com/2072-6694/12/2/258oldoral cavity squamous cell carcinomalocally advancedtreatmentsmortality |
| spellingShingle | Ben-Chang Shia Lei Qin Kuan-Chou Lin Chih-Yuan Fang Lo-Lin Tsai Yi-Wei Kao Szu-Yuan Wu Outcomes for Elderly Patients Aged 70 to 80 Years or Older with Locally Advanced Oral Cavity Squamous Cell Carcinoma: A Propensity Score–Matched, Nationwide, Oldest Old Patient–Based Cohort Study Cancers old oral cavity squamous cell carcinoma locally advanced treatments mortality |
| title | Outcomes for Elderly Patients Aged 70 to 80 Years or Older with Locally Advanced Oral Cavity Squamous Cell Carcinoma: A Propensity Score–Matched, Nationwide, Oldest Old Patient–Based Cohort Study |
| title_full | Outcomes for Elderly Patients Aged 70 to 80 Years or Older with Locally Advanced Oral Cavity Squamous Cell Carcinoma: A Propensity Score–Matched, Nationwide, Oldest Old Patient–Based Cohort Study |
| title_fullStr | Outcomes for Elderly Patients Aged 70 to 80 Years or Older with Locally Advanced Oral Cavity Squamous Cell Carcinoma: A Propensity Score–Matched, Nationwide, Oldest Old Patient–Based Cohort Study |
| title_full_unstemmed | Outcomes for Elderly Patients Aged 70 to 80 Years or Older with Locally Advanced Oral Cavity Squamous Cell Carcinoma: A Propensity Score–Matched, Nationwide, Oldest Old Patient–Based Cohort Study |
| title_short | Outcomes for Elderly Patients Aged 70 to 80 Years or Older with Locally Advanced Oral Cavity Squamous Cell Carcinoma: A Propensity Score–Matched, Nationwide, Oldest Old Patient–Based Cohort Study |
| title_sort | outcomes for elderly patients aged 70 to 80 years or older with locally advanced oral cavity squamous cell carcinoma a propensity score matched nationwide oldest old patient based cohort study |
| topic | old oral cavity squamous cell carcinoma locally advanced treatments mortality |
| url | https://www.mdpi.com/2072-6694/12/2/258 |
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