Treatment strategies for and outcomes of older patients with oral squamous cell carcinoma.

OBJECTIVE: The purpose of this study was to investigate factors that have a significant impact on decision making regarding treatment strategies and on the resultant outcomes in older patients with oral squamous cell carcinoma (OSCC). STUDY DESIGN: To define fit, vulnerable, and frail patients, as well as treatment strategies/outcomes, in patients 75 years of age and older with primary OSCC were retrospectively reviewed from the medical records. RESULTS: Among patients with stage I and II tumors, those with a Geriatric 8 (G8) score of 11.5 or greater had favorable outcomes and those with a score less than 11.5 had acceptable outcomes (5-year self-reliance [SR] rates: 80.8 and 53.5%, respectively). Among patients with stage III and IV tumors, those with the Eastern Cooperative Oncology Group-Performance status (ECOG-PS) score less than 2 and/or a G8 score 11.5 or greater mainly received standard therapy, had favorable outcomes (5-year SR rate: 66.7%). The 5-year SR rates of stage IV patients with an ECOG-PS score 2 or greater and those with a G8 score less than 11.5 were poor regardless of any treatment strategy. Although the 5-year SR rate of patients with standard therapy was 73.4%, that of patients receiving other curative therapies was 0%. CONCLUSIONS: In patients with stage III/IV, ECOG-PS 2 or greater, and/or G8 score less than 11.5, treatment was difficult, and the prognosis was poor.