Elderly Patients with Advanced Head and Neck Carcinoma: Does Aggressive Treatment Result in Better Outcomes?
Otolaryngol Head Neck Surg
; 160(4): 642-650, 2019 04.
Article
em En
| MEDLINE
| ID: mdl-30558490
ABSTRACT
OBJECTIVE:
There are no well-defined treatment recommendations for elderly patients with advanced head and neck squamous cell carcinoma. This study aimed to investigate whether aggressive treatment among the elderly translated into better survival outcomes. STUDYDESIGN:
Retrospective cohort study.SETTING:
Single tertiary institution. SUBJECTS ANDMETHODS:
Elderly patients (≥60 years) with advanced-stage head and neck squamous cell carcinoma (stage III and IV) treated between January 1991 and May 2014 were reviewed. According to current National Comprehensive Cancer Network guidelines, they were classified to have received standard or substandard treatment. Overall survival (OS), locoregional recurrence-free survival, and distant recurrence-free survival were evaluated.RESULTS:
A total of 355 patients were treated curatively 194 with up-front surgery and 161 with radiotherapy or concurrent chemotherapy and radiotherapy. Median OS was higher among patients who received standard treatment (42.0 vs 16.0 months, P < .001). On multivariate analysis, standard treatment showed superior OS ( P < .001). Use of substandard treatment showed a hazard ratio of 2.09 (95% CI, 1.59-2.74) for poorer OS.CONCLUSION:
Aggressive standard treatment protocols should be advocated for elderly patients, where comorbidities permit, as they confer better outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Carcinoma de Células Escamosas
/
Neoplasias de Cabeça e Pescoço
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Otolaryngol Head Neck Surg
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Singapura