2019 年 68 巻 1 号 p. 12-19
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.