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Management of elderly patients with head and neck carcinoma: analysis of outcomes for radical versus palliative treatment

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Abstract

Background

There are no universally accepted treatment recommendations for elderly patients with head and neck carcinomas. This study investigated whether radical treatment in elderly patients resulted in better survival compared with palliative treatment.

Methods

We retrospectively reviewed the medical records of 724 patients aged > 60 years who underwent treatment for primary head and neck carcinomas at Hamamatsu University Hospital. We evaluated the impact of the following: age, sex, the clinical stage, smoking history, alcohol use history, primary tumor site, performance status, and Osaka Head and Neck Comorbidity Index score on overall survival using a Cox proportional hazards model.

Results

The 5-year overall survival rate was significantly greater for the 646 patients initially treated with radical (curative) therapy than for the 78 patients treated with palliative therapy (p < 0.01). Patients who received palliative treatment in all age groups were more likely to die than were those in the radical treatment group, after controlling for age, sex, and clinical stage of the cancer. Information on the survival status of patients was obtained after a mean follow-up period of 46 months (range 6–205 months).

Conclusions

In the absence of contraindications associated with comorbidities, radical treatment protocols should be recommended for elderly patients with head and neck carcinomas because they confer better survival.

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Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Shizuoka, Japan

    Seiji Hosokawa, Goro Takahashi, Jun Okamura, Atsushi Imai, Daiki Mochizuki, Ryuji Ishikawa, Yoshinori Takizawa, Takashi Yamatodani, Kiyoshi Misawa & Hiroyuki Mineta

  2. Yamahoshi ENT Clinic, 1-4-6 Shitoro, Nishi-ku, Hamamatsu, 432-8069, Shizuoka, Japan

    Goro Takahashi

Authors
  1. Seiji Hosokawa
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  2. Goro Takahashi
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  3. Jun Okamura
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  4. Atsushi Imai
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  5. Daiki Mochizuki
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  6. Ryuji Ishikawa
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  7. Yoshinori Takizawa
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  8. Takashi Yamatodani
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  9. Kiyoshi Misawa
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  10. Hiroyuki Mineta
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Corresponding author

Correspondence to Seiji Hosokawa.

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Conflict of interest

The authors declare no conflicts of interest. All authors have full control of all primary data and agree to allow the journal to review their data if requested.

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Hosokawa, S., Takahashi, G., Okamura, J. et al. Management of elderly patients with head and neck carcinoma: analysis of outcomes for radical versus palliative treatment. Int J Clin Oncol 25, 432–438 (2020). https://doi.org/10.1007/s10147-019-01531-w

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  • DOI: https://doi.org/10.1007/s10147-019-01531-w

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