Age and stage as determinants of treatment for oral cavity and oropharyngeal cancers in the elderly

Background We investigate treatment selection for oral cavity and oropharyngeal (OC&OP) cancers to understand factors that influence treatment selection. Methods We studied 7023 patients, ≥66 years, diagnosed with a first primary OC&OP cancer using SEER-Medicare data. Multinomial logistic regression was to model treatment selection, controlling for other factors. Results Most patients with OC cancer were treated with surgery alone (56.5%); most patients with OP cancer were treated with chemotherapy and radiation (28.9%). Age, stage and site were the most important predictors of treatment selection. As age increased from 70 to 81 (the interquartile range), treatment shifted toward surgery alone (OR = 1.26; CI: 1.08-1.46) and no treatment (OR = 1.5, 95% CI: 1.25-1.80), and away from combined surgery, radiation and treatments involving chemotherapy. Conclusions Age, stage, and site are the most important determinants of treatment selection for patients with OC&OP cancers. Increasing age and stage drive treatment toward non-surgical options and no treatment at all.