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Anticancer Res. 2017 Apr;37(4):1847-1851.

Human Papilloma Virus-positive Oropharyngeal Squamous Cell Carcinoma in the Elderly.

Author information

1
Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
2
Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
3
Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
4
Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
5
Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
6
Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A. richard.bakst@mountsinai.org.

Abstract

BACKGROUND/AIM:

Elderly patients with HPV+ oropharyngeal cancer (OPC) represent an understudied cohort of the HPV epidemic. We aimed to investigate the clinical presentation, treatment tolerability and outcomes in patient's ≥65 years old with HPV+ OPC.

PATIENTS AND METHODS:

We identified all patients aged 65 and older treated at our Institution with HPV+ OPC and analyzed patient demographics, disease characteristics, treatment modalities, toxicities, treatment failures, and survival. Charlson comorbidity index was calculated for each patient.

RESULTS:

43 patients were identified with a mean age of median age was 70.0 (range 65-86). The mean Charlson comorbidity index score for the cohort was 5.2. In total, 72.1% of patients received what was considered standard-of-care based on stage and pathological features. Nine point three percent of patients required RT-related treatment breaks with the majority being women (75%). Three-year actuarial overall survival was 85.5% (95% CI: 71.4%-100%) and 3-year disease-free survival was 67.3% (95% CI: 49.7-91.0%).

CONCLUSION:

This study presented one of the largest series to date evaluating HPV-related OPC in patients ≥65. Elderly individuals with HPV+ OPC have favorable overall survival with high treatment tolerability independent of Charlson co-morbidity score. Elderly patients should be considered for stage-appropriate care with omission of specific therapies based on absolute contraindications and patient preference, but not assumptions regarding tolerability.

KEYWORDS:

HPV; elderly; head & neck cancer

PMID:
28373450
DOI:
10.21873/anticanres.11520
[Indexed for MEDLINE]

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