The prognostic significance of age in oropharyngeal squamous cell carcinoma

Objectives: Though the effect of age has been studied in some cancer types, its prognostic significance in oropharyngeal squamous cell carcinoma (OPSCC) remains controversial. Our purpose is to determine the impact of age at diagnosis on overall survival (OS) and disease-specific survival (DSS) in patients with OPSCC. If the effect is significant, we aim to clarify the age at which prognosis worsens.

Materials and methods: 15,978 Patients with OPSCC were identified from the Surveillance, Epidemiology, and End Results (SEER) database and separated into 10 year age groups. We obtained data on age at diagnosis, primary location, race, stage, sex, radiological treatment status, and surgical treatment status. Kaplan-Meier methods were used to calculate the OS and DSS for each age group. DSS analysis was supported by a Simple Multivariable Cox Proportional Hazard Regression of all significant variables studied.

Results: Significant disadvantage in OS and DSS was found with increasing age. A three-group stratification was depicted with the best survival in patients aged 1-44, mildly inferior survival in patients aged 45-64, and increasingly worse survival in patients 65 and older. Multivariable analysis demonstrated statistically significant increases in hazard ratio (HR) after age 65 when compared to ages 1-64.

Conclusion: Increasing age after 65 is associated with worsening OS and DSS in OPSCC. Poorer prognosis is due to multiple factors, possibly including the effects of aging, which make elderly patients more susceptible to the pathogenesis of OPSCC.