Abstract
From 1982 to 1992, 29 elderly patients, 80 years old and older, with malignancies in head and neck were treated at the Department of Oral and Maxillofacial Surgery, Yokohama City University. Twelve cases were male and 17 were female, and 26 cases were primary and 3 were secondary. A pathological diagnosis revealed that 26 cases were squamous cell carcinoma (90%) . Frequent sites were the tongue in 7 cases, the buccal mucosa in 6 and the upper gingiva in 4.
As for TNM classification (1987), 2 cases were Stage I, 8 were Stage II, 5 were Stage III and 12 were Stage IV.
The patients were classified into three therapeutic groups, surgery, radiation (curative) and palliative, and the survival rate was studied by the KaplamMeier method. The survival rates of surgery was 15% in 3 and 5 years, radiation was 30% in 3 and 5 years, and palliative was 0 % in one year. The survival rates of curative therapy were as follows : Stage I and II were 50% in 5 years and Stage III and IV were 0 % in 3 years. Unfortunately, 7 cases (50%) died of other causes in the curative group. This was a very high rate and showed traits of malignancy treatment in elderly patients.
From the results, it is most important for elderly patients to undergo appropriate therapy selected by physical and psychological examinations. In fact, performance status was the most helpful information for the evaluation of their conditions. Treatment should maintain the quality of life, especially in elderly patients.
