Artikel
Prognostic impact of age on recurrence free survival in head and neck cancer
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Veröffentlicht: | 22. September 2005 |
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Gliederung
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Head and neck cancer has its peak incidence within the 6th decade. Case reports suggest that prognosis gets worse when carcinomas occur in younger age. This assumption was investigated in a retrospective analysis.
The files of all patients with cancer of oral cavity, oropharynx, hypopharynx and larynx treated by means of surgery between 1970 and 1990 under curative conditions, were analyzed. Patients with distant metastasis were excluded from this analysis. Survival functions were calculated using the product limit method by Kaplan-Meier in dependence from age and other accepted prognostic factors. The logrank test was used for comparing survival rates.
2703 fulfilled inclusion criteria; the mean age of this group was 57,8±11,8 years. The youngest patient was 15 years of age, the oldest 93 years. 370 patients (13,7%) were younger than 45 years. The 5-year recurrence free survival rate of these younger patients was significantly worse than that of the older patients (49% compared to 60%, p<0,0001). Gender showed no prognostic influence. In the younger patients UICC stage IV occurred more frequently than in the older patients (49,5% vs. 36,9%).
It is to be concluded that worse prognosis in younger patients is predominantly a function of tumor extension and dissemination. Therefore it seems necessary to intensify multimodal therapy in the younger age group.