Effect of age and gender in non-smokers with oral squamous cell carcinoma: Multi-institutional study.

Age Factors Aged Female Humans Male Middle Aged Mouth Neoplasms / epidemiology Non-Smokers / statistics & numerical data Prognosis Retrospective Studies Sex Factors Squamous Cell Carcinoma of Head and Neck / epidemiology
Age Gender Non-smokers Oral cancers Oral squamous cell carcinoma Tongue

Journal

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

Informations de publication

Date de publication:
05 2021
Historique:
received: 28 09 2020
revised: 12 01 2021
accepted: 25 01 2021
pubmed: 23 2 2021
medline: 1 2 2022
entrez: 22 2 2021
Statut: ppublish

Résumé

In developing countries, oral squamous cell carcinoma (OSCC) is predominantly a cancer affecting older males who smoke tobacco. In countries with effective public health strategies, smoking rates are declining rapidly. It is not clear if patients who develop OSCC without these traditional risk factors represent a clinically distinct cohort with different prognosis. A recent analysis found that elderly non-smoking females with OSCC had significantly worse prognosis, concluding that this was a distinct patient population with poorer survival. The primary aim of this study was to determine the effect of gender and age on prognosis in OSCC, and the interaction between these two variables. Multinational multi-institutional data were collected from six sites. The primary outcome of interest was disease specific survival (DSS). Time to local, regional, and distant recurrence were investigated as secondary outcomes. 3379 patients with OSCC were included. Males had significantly worse DSS compared to females (HR 1.24, 95% CI 1.08-1.43, p = 0.003). Females <70 years of age had significantly better DSS compared to females ≥70 years of age (HR 0.69, 95% CI 0.51-0.94, p < 0.001) but elderly females had similar DSS to males, regardless of age. When age was divided into three groups, the middle-aged group (45-69 years) had a significantly better DSS compared to elderly patients (HR 0.87, 95%CI 0.78-0.96, p < 0.001), however younger patients had similar DSS to elderly patients. When the effect of age (young v middle v elderly) was compared in each gender, young and middle-aged females had the most favourable DSS (log-rank p < 0.001). Middle-aged females who smoked had a 10% survival advantage compared to middle-aged males that smoked at five years. Age, gender, tumour subsite, and smoking status are important drivers of survival in OSCC. However, gender appears to be the most important predictor with young and middle-aged females having the most favourable prognosis.

Sections du résumé

BACKGROUND
In developing countries, oral squamous cell carcinoma (OSCC) is predominantly a cancer affecting older males who smoke tobacco. In countries with effective public health strategies, smoking rates are declining rapidly. It is not clear if patients who develop OSCC without these traditional risk factors represent a clinically distinct cohort with different prognosis. A recent analysis found that elderly non-smoking females with OSCC had significantly worse prognosis, concluding that this was a distinct patient population with poorer survival. The primary aim of this study was to determine the effect of gender and age on prognosis in OSCC, and the interaction between these two variables.
METHODS
Multinational multi-institutional data were collected from six sites. The primary outcome of interest was disease specific survival (DSS). Time to local, regional, and distant recurrence were investigated as secondary outcomes.
RESULTS
3379 patients with OSCC were included. Males had significantly worse DSS compared to females (HR 1.24, 95% CI 1.08-1.43, p = 0.003). Females <70 years of age had significantly better DSS compared to females ≥70 years of age (HR 0.69, 95% CI 0.51-0.94, p < 0.001) but elderly females had similar DSS to males, regardless of age. When age was divided into three groups, the middle-aged group (45-69 years) had a significantly better DSS compared to elderly patients (HR 0.87, 95%CI 0.78-0.96, p < 0.001), however younger patients had similar DSS to elderly patients. When the effect of age (young v middle v elderly) was compared in each gender, young and middle-aged females had the most favourable DSS (log-rank p < 0.001). Middle-aged females who smoked had a 10% survival advantage compared to middle-aged males that smoked at five years.
CONCLUSIONS
Age, gender, tumour subsite, and smoking status are important drivers of survival in OSCC. However, gender appears to be the most important predictor with young and middle-aged females having the most favourable prognosis.

Identifiants

DOI: 10.1016/j.oraloncology.2021.105210 PMID: 33618102
pubmed: 33618102
pii: S1368-8375(21)00033-6
doi: 10.1016/j.oraloncology.2021.105210
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

105210

Informations de copyright

Copyright © 2021. Published by Elsevier Ltd.

Auteurs

Lawrence J Oh (LJ)

Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, NSW, Australia. Electronic address: lawrence.oh90@gmail.com.

Rebecca Asher (R)

Chris O'Brien Lifehouse, Camperdown, NSW, Australia.

Michael Veness (M)

Department of Radiation Oncology, 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, Princess Margaret Hospital, 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)

Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kerala, India.

Tsu-Hui Hubert Low (TH)

Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, NSW, Australia.

Carsten E Palme (CE)

Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, NSW, Australia.

Ruta Gupta (R)

Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, NSW, Australia; Department of Tissue Pathology, NSW Health Pathology, Camperdown, Sydney, Australia.

Jonathan Clark (J)

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

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Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Facteurs âges › Effect of age and gender in non-smokers with...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Effect of age and gender in non-smokers with...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Effect of age and gender in non-smokers with...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Effect of age and gender in non-smokers with...
questionsmedicales.fr › Maladies du système stomatognathique › Maladies de la bouche › Tumeurs de la bouche › Effect of age and gender in non-smokers with...
questionsmedicales.fr › Personnes › Non-fumeurs › Effect of age and gender in non-smokers with...
questionsmedicales.fr › Diagnostic › Pronostic › Effect of age and gender in non-smokers with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Effect of age and gender in non-smokers with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Facteurs sexuels › Effect of age and gender in non-smokers with...
questionsmedicales.fr › Tumeurs › Tumeurs par siège › Tumeurs de la tête et du cou › Carcinome épidermoïde de la tête et du cou › Effect of age and gender in non-smokers with...