Bhattacharyya Neil
Division of Otolaryngology, Brigham and Women's Hospital, and the Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
Laryngoscope. 2003 Feb;113(2):368-72. doi: 10.1097/00005537-200302000-00030.
To determine whether elderly patients manifest poorer survivals for head and neck squamous cell carcinoma.
Cases of squamous cell carcinoma of the glottic larynx, oral tongue, and tonsil were extracted from the Surveillance, Epidemiology and End Results database for 1988 to 1998. For each primary site, patients were segregated into two age groups: 50 to 69 years of age and 70 years of age and older. For each case in the latter, elderly group, a reference group case was randomly matched for gender, year of diagnosis, cancer stage, extent of surgery, and radiation therapy. Overall survival and disease-specific survival were compared between the two groups with stage stratification with the Kaplan-Meier method.
Cases of glottic carcinoma (1882), tongue carcinoma (426), and tonsillar carcinoma (200) in elderly patients were matched to the reference group. Overall mean survival differences were significant for glottic carcinoma (73.9 vs. 96.7 mo, elderly and younger groups, respectively) (P <.001) and tongue carcinoma (59.5 vs. 73.1 mo) ( P=.002) but not for tonsillar carcinoma (46.0 vs. 54.4 mo) ( P=.220). Disease-specific survival differences were significant but small in magnitude for glottic carcinoma (105.9 vs. 114.1 mo, respectively (P <.001) and tongue carcinoma (81.6 vs. 93.6 mo) (P =.009) but not for tonsillar carcinoma (71.5 vs. 70.7 mo) (P =.422). However, after stage stratification, elderly patients often did not exhibit statistically or practically significant poorer overall or disease-specific survivals.
Elderly patients do not necessarily exhibit clinically significant poorer survivals for head and neck squamous cell carcinoma. Age alone should not be used to determine treatment options for elderly patients with squamous cell carcinoma.
确定老年头颈部鳞状细胞癌患者的生存率是否更低。
从监测、流行病学和最终结果数据库中提取1988年至1998年声门喉、口腔舌和扁桃体鳞状细胞癌病例。对于每个原发部位，患者被分为两个年龄组：50至69岁和70岁及以上。对于老年组中的每个病例，随机匹配一个参考组病例，使其在性别、诊断年份、癌症分期、手术范围和放疗方面与之相同。采用Kaplan-Meier法对两组进行分期分层，比较总生存率和疾病特异性生存率。
老年患者的声门癌（1882例）、舌癌（426例）和扁桃体癌（200例）病例与参考组匹配。声门癌（老年组和年轻组分别为73.9个月和96.7个月）（P<.001）和舌癌（59.5个月和73.1个月）（P=.002）的总平均生存差异具有统计学意义，但扁桃体癌（46.0个月和54.4个月）（P=.220）无差异。声门癌（分别为105.9个月和114.1个月）（P<.001）和舌癌（81.6个月和93.6个月）（P=.009）的疾病特异性生存差异具有统计学意义，但幅度较小，扁桃体癌（71.5个月和70.7个月）（P=.422）无差异。然而，在分期分层后，老年患者通常在统计学或实际意义上并未表现出总体或疾病特异性生存率明显更低。
老年头颈部鳞状细胞癌患者不一定在临床上表现出明显更低的生存率。不应仅根据年龄来确定老年鳞状细胞癌患者的治疗方案。
