373P - Investigating the impact of treatment on geriatric patients with locally advanced head and neck squamous cell carcinoma

Background

Head and neck squamous cell carcinoma (HNSCC) is a common cancer worldwide with high mortality rates. Studies suggested the incidence of HNSCC will increase by approximately 30% by 2030. However, elderly patients with advanced HNSCC often face challenges in receiving sufficient treatment because of their lower tolerance to therapy. Exploring different approaches for HNSCC is crucial given the world's aging population.

Methods

The study between 2010 and 2021 involved patients with HNSCC located in the oral cavity, oropharynx, larynx, and hypopharynx. The research was focused on advanced-stage patients aged 70 or older. The data were collected from a cancer registry database at a referral institution. The Kaplan-Meier method was used to estimate overall survival (OS).

Results

The study included 1144 patients with HNSCC, of whom 207 (18.1%) were above 70 years old. Over 50% of the patients had advanced disease without metastasis, being stages III, IVA and IVB. The median OS for geriatric patients with advanced disease was 16.1 months. Patients who underwent curative-intent surgery, radiotherapy, or chemoradiotherapy had better survival rates than those who did not (log-rank test: all p < .01). Furthermore, patients with a higher body mass index (≥ 18.5) had improved OS (p = .03). No significant differences were observed in OS between geriatric patients who received systemic therapy or not. By the multivariate analysis, patients who underwent surgery demonstrated higher survival rates, while those with tumors located in the hypopharynx showed inferior outcomes. The median OS was 29.9 and 8.4 months, respectively (p < .01 and p = .01). Table: 373P

AJCC stage III and IV (M0) head and neck cancer (p < .01)

Conclusions

Geriatric patients with locally advanced HNSCC have a poor prognosis especially for hypopharyngeal cancer. The study suggests that curative surgery may be a beneficial treatment for these patients. However, further research is warranted to optimize treatments and improve outcomes and quality of life for this vulnerable group.

Clinical trial identification

Editorial acknowledgement

The authors would like to thank all colleagues who contributed to this study. The work was supported by the medical integration database of National Taiwan University Hospital and National Taiwan University Hospital Yunlin branch.

Legal entity responsible for the study

Y.T. Liu.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.