Abstract
Objective: While squamous cell carcinoma of the head and neck (HNSCC) most commonly affects individuals in the fifth to seventh decades of life, it occasionally arises in older patients. Biologic and epidemiologic factors of HNSCC in elderly patients have been investigated to shed light on the process of neoplastic transformation in that population. Design: The medical records of patients with new onset of HNSCC presenting between 1988 and 1993 were reviewed retrospectively. Setting: Tertiary-care hospital-based clinic. Patients: Eighty-one individuals who developed HNSCC of the upper aerodigestive tract after their 75th birthday constituted the study group. A control group consisting of 102 patients who developed HNSCC between the ages of 40 and 70 years was also analyzed. Main Outcome Measure: Information about each individual's tobacco and ethanol exposure, family history of cancer, history of second primary cancer, treatment provided, and current disease status were derived from the medical record. The presence or absence of p53 gene mutation was tabulated for a subset of individuals in both the elderly and the middle-aged groups. Results: The elderly patients had a significantly lower degree of alcohol and tobacco exposure, but a significantly higher rate of second primary cancers, especially in sites outside the upper aerodigestive tract. There was no difference in the incidence of cancer in first-degree relatives in the two groups. These findings were interpreted in light of results from our laboratory examining the incidence of p53 gene mutation in a large number of patients with HNSCC. A significantly higher percentage of tumors from the younger group contained a p53 gene mutation. Major surgery was an integral part of the treatment plan for most of the older patient group despite their advanced age. Conclusions: These findings suggest that HNSCC arising after the seventh decade of life less frequently involves a genetic change commonly found in younger patients. Heavy carcinogen exposure and p53 gene mutations are present less often in elderly individuals, whereas this group appears to be more susceptible to multiple cancers. The precise biologic factors involved in neoplastic transformation in this older population await discovery. Since aggressive therapy can be successfully tolerated by many elderly patients, an individualized approach to treatment is advocated.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 262-265 |
| Number of pages | 4 |
| Journal | Archives of Otolaryngology--Head and Neck Surgery |
| Volume | 121 |
| Issue number | 3 |
| DOIs | |
| State | Published - 1995 |
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ASJC Scopus subject areas
- Otorhinolaryngology
- Surgery
Cite this
Squamous Cell Carcinoma of the Head and Neck in the Elderly. / Koch, Wayne Martin; Patel, Himanshu; Brennan, Joseph; Boyle, Jay O.; Sidransky, David.
In: Archives of Otolaryngology--Head and Neck Surgery, Vol. 121, No. 3, 1995, p. 262-265.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Squamous Cell Carcinoma of the Head and Neck in the Elderly
AU - Koch, Wayne Martin
AU - Patel, Himanshu
AU - Brennan, Joseph
AU - Boyle, Jay O.
AU - Sidransky, David
PY - 1995
Y1 - 1995
N2 - Objective: While squamous cell carcinoma of the head and neck (HNSCC) most commonly affects individuals in the fifth to seventh decades of life, it occasionally arises in older patients. Biologic and epidemiologic factors of HNSCC in elderly patients have been investigated to shed light on the process of neoplastic transformation in that population. Design: The medical records of patients with new onset of HNSCC presenting between 1988 and 1993 were reviewed retrospectively. Setting: Tertiary-care hospital-based clinic. Patients: Eighty-one individuals who developed HNSCC of the upper aerodigestive tract after their 75th birthday constituted the study group. A control group consisting of 102 patients who developed HNSCC between the ages of 40 and 70 years was also analyzed. Main Outcome Measure: Information about each individual's tobacco and ethanol exposure, family history of cancer, history of second primary cancer, treatment provided, and current disease status were derived from the medical record. The presence or absence of p53 gene mutation was tabulated for a subset of individuals in both the elderly and the middle-aged groups. Results: The elderly patients had a significantly lower degree of alcohol and tobacco exposure, but a significantly higher rate of second primary cancers, especially in sites outside the upper aerodigestive tract. There was no difference in the incidence of cancer in first-degree relatives in the two groups. These findings were interpreted in light of results from our laboratory examining the incidence of p53 gene mutation in a large number of patients with HNSCC. A significantly higher percentage of tumors from the younger group contained a p53 gene mutation. Major surgery was an integral part of the treatment plan for most of the older patient group despite their advanced age. Conclusions: These findings suggest that HNSCC arising after the seventh decade of life less frequently involves a genetic change commonly found in younger patients. Heavy carcinogen exposure and p53 gene mutations are present less often in elderly individuals, whereas this group appears to be more susceptible to multiple cancers. The precise biologic factors involved in neoplastic transformation in this older population await discovery. Since aggressive therapy can be successfully tolerated by many elderly patients, an individualized approach to treatment is advocated.
AB - Objective: While squamous cell carcinoma of the head and neck (HNSCC) most commonly affects individuals in the fifth to seventh decades of life, it occasionally arises in older patients. Biologic and epidemiologic factors of HNSCC in elderly patients have been investigated to shed light on the process of neoplastic transformation in that population. Design: The medical records of patients with new onset of HNSCC presenting between 1988 and 1993 were reviewed retrospectively. Setting: Tertiary-care hospital-based clinic. Patients: Eighty-one individuals who developed HNSCC of the upper aerodigestive tract after their 75th birthday constituted the study group. A control group consisting of 102 patients who developed HNSCC between the ages of 40 and 70 years was also analyzed. Main Outcome Measure: Information about each individual's tobacco and ethanol exposure, family history of cancer, history of second primary cancer, treatment provided, and current disease status were derived from the medical record. The presence or absence of p53 gene mutation was tabulated for a subset of individuals in both the elderly and the middle-aged groups. Results: The elderly patients had a significantly lower degree of alcohol and tobacco exposure, but a significantly higher rate of second primary cancers, especially in sites outside the upper aerodigestive tract. There was no difference in the incidence of cancer in first-degree relatives in the two groups. These findings were interpreted in light of results from our laboratory examining the incidence of p53 gene mutation in a large number of patients with HNSCC. A significantly higher percentage of tumors from the younger group contained a p53 gene mutation. Major surgery was an integral part of the treatment plan for most of the older patient group despite their advanced age. Conclusions: These findings suggest that HNSCC arising after the seventh decade of life less frequently involves a genetic change commonly found in younger patients. Heavy carcinogen exposure and p53 gene mutations are present less often in elderly individuals, whereas this group appears to be more susceptible to multiple cancers. The precise biologic factors involved in neoplastic transformation in this older population await discovery. Since aggressive therapy can be successfully tolerated by many elderly patients, an individualized approach to treatment is advocated.
UR - http://www.scopus.com/inward/record.url?scp=0028961703&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028961703&partnerID=8YFLogxK
U2 - 10.1001/archotol.1995.01890030006001
DO - 10.1001/archotol.1995.01890030006001
M3 - Article
C2 - 7873140
AN - SCOPUS:0028961703
VL - 121
SP - 262
EP - 265
JO - Archives of Otolaryngology
JF - Archives of Otolaryngology
SN - 2168-6181
IS - 3
ER -