A clinical study of super-elderly patients over 90 years old with oral cancer

Abstract

Twenty-seven super-elderly patients, 90 years old or older, who accounted for 3.6％ of the total of 740 patients with oral cancer referred to our clinic from April 1997 to December 2017, were clinically evaluated. This super-elderly group was compared with each group aged 16–64, 65–74 and 75–89.
This group consisted of 6 males and 21 females. Tumors were most frequently located in the lower gingiva（10 cases: 37.0％）, and 91.0％ of histological type was squamous cell carcinoma（20 cases）. By stage classification, stage Ⅳ was the most frequent（13 cases: 59.1％）. 96.3％ of super-elderly patients had systemic medical complications, and performance status（PS） 3 was the most frequent（13 cases: 48.2％）. As for the treatment modality, radical treatments and palliative treatments were performed for 3 cases（11.2％） and 13 cases（48.1％） respectively, and 11 cases（40.7％） were untreated. The ratio of the radical treatment group was significantly lower than that in each group under 90 years old（p＜0.001）. There was a significant difference in the choice of treatment modality by PS and staging（p＜0.05）. The cause-specific survival rate was significantly lower than that in each group under 90 years old（p＜0.001）. There was a significant difference in the cause-specific survival rates between the treated group and untreated group（p＝0.023）.
These results suggest that radical treatments and palliative treatments for super-elderly patients over 90 years old can improve the prognosis, and PS and stage classification may be considered when selecting the treatment modality.