Young age is not a predictor of disease specific survival in oral cancer: A multi-institutional study.

Age Factors Cohort Studies Female Humans Male Middle Aged Mouth Neoplasms / epidemiology Prognosis Survival Analysis
Cancer Oncology Oral Squamous cell carcinoma Survival

Journal

Oral oncology
ISSN: 1879-0593
Titre abrégé: Oral Oncol
Pays: England
ID NLM: 9709118

Informations de publication

Date de publication:
04 2021
Historique:
received: 11 06 2020
revised: 18 12 2020
accepted: 20 12 2020
pubmed: 7 2 2021
medline: 18 11 2021
entrez: 6 2 2021
Statut: ppublish

Résumé

Over the last few decades evidence has accumulated for increasing incidence of oral cavity squamous cell carcinoma (OSCC) in a younger cohort. Prior studies examining the effect of age at diagnosis on prognosis have produced conflicting data. A multi-institutional cohort study was performed across 6 different sites in Australia, Canada, India and Singapore. Disease-free (DFS), overall (OS) and disease-specific (DSS) survival were analysed. The association of the number of adverse features with survival outcomes was investigated. From 3179 patients, age was a significant predictor of OS with patients older than 45 years having a 66% increased risk of death (HR 1.66, 95%CI 1.33 - 2.07, p < 0.001). The number of adverse features was a significant predictor of OS with 3 or more adverse features having a 199% increased risk (HR 2.99, 95%CI 2.61-3.43. p < 0.001). The estimate effect was greater in patients ≤ 45 years (HR 3.49 vs HR 2.81). Age was not a significant predictor of DSS with similar rates of death from OSCC in multivariable models. The number of adverse features was a significant predictor of DFS with ≥ 3 adverse features having a 140% increased risk of death. The number of adverse features was a significant predictor of DSS with ≥ 3 adverse features having a 230% increased risk of disease specific death. Age is not an independent predictor of disease specific mortality in OSCC. Differences in outcomes are due to the confounding effect of adverse clinicopathological features and the ability to tolerate surgery and adjuvant therapy.

Sections du résumé

BACKGROUND
Over the last few decades evidence has accumulated for increasing incidence of oral cavity squamous cell carcinoma (OSCC) in a younger cohort. Prior studies examining the effect of age at diagnosis on prognosis have produced conflicting data.
METHODS
A multi-institutional cohort study was performed across 6 different sites in Australia, Canada, India and Singapore. Disease-free (DFS), overall (OS) and disease-specific (DSS) survival were analysed. The association of the number of adverse features with survival outcomes was investigated.
RESULTS
From 3179 patients, age was a significant predictor of OS with patients older than 45 years having a 66% increased risk of death (HR 1.66, 95%CI 1.33 - 2.07, p < 0.001). The number of adverse features was a significant predictor of OS with 3 or more adverse features having a 199% increased risk (HR 2.99, 95%CI 2.61-3.43. p < 0.001). The estimate effect was greater in patients ≤ 45 years (HR 3.49 vs HR 2.81). Age was not a significant predictor of DSS with similar rates of death from OSCC in multivariable models. The number of adverse features was a significant predictor of DFS with ≥ 3 adverse features having a 140% increased risk of death. The number of adverse features was a significant predictor of DSS with ≥ 3 adverse features having a 230% increased risk of disease specific death.
CONCLUSIONS
Age is not an independent predictor of disease specific mortality in OSCC. Differences in outcomes are due to the confounding effect of adverse clinicopathological features and the ability to tolerate surgery and adjuvant therapy.

Identifiants

DOI: 10.1016/j.oraloncology.2020.105162 PMID: 33548861
pubmed: 33548861
pii: S1368-8375(20)30598-4
doi: 10.1016/j.oraloncology.2020.105162
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

105162

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Auteurs

Lawrence J Oh (LJ)

Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, NSW, Australia.

Laveniya Satgunaseelan (L)

Department of Tissue Pathology and Diagnostic Oncology, New South Wales Health Pathology, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.

Rebecca Asher (R)

Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.

Michael Veness (M)

Department of Radiation Oncology, Crown Mary Westmead Cancer Centre, Westmead Hospital, Westmead, NSW, Australia.

Robert Smee (R)

Department of Radiation Oncology, Prince of Wales Hospital, Randwick, NSW, Australia.

David Goldstein (D)

Department of Otolaryngology Head and Neck Surgery, University of Toronto, Toronto, Canada.

N Gopalakrishna Iyer (N)

Department of Head & Neck Surgery, Division of Surgery & Surgical Oncology, Duke-NUS Centre, Singapore.

Deepak Balasubramanian (D)

Centre for Head and Neck Surgery and Oncology, Surgical Oncology, Amrita Hospital, Fridabad, India.

Hubert Low (H)

Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, NSW, Australia.

Carsten E Palme (CE)

Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, NSW, Australia.

Ruta Gupta (R)

Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia; Department of Tissue Pathology and Diagnostic Oncology, New South Wales Health Pathology, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.

Jonathan R Clark (JR)

Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, NSW, Australia. Electronic address: jonathan.clark@lh.org.au.

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Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Facteurs âges › Young age is not a predictor of disease...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Young age is not a predictor of disease...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Young age is not a predictor of disease...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Young age is not a predictor of disease...
questionsmedicales.fr › Maladies du système stomatognathique › Maladies de la bouche › Tumeurs de la bouche › Young age is not a predictor of disease...
questionsmedicales.fr › Diagnostic › Pronostic › Young age is not a predictor of disease...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de survie › Young age is not a predictor of disease...