Outcome Differences in Younger and Older Patients with Laryngeal Cancer: a Retrospective Case-control Study

Purpose: Younger or older age has a significant impact on the outcome of patients with head and neck cancer. However, the data regarding outcomes based on age are conflicting. The aim of this article is to determine the impact of age on the outcome of laryngeal cancer.

Materials And Methods: A retrospective study was performed including all patients with squamous cell carcinoma of the larynx for over a 9-year period. The patients were divided into 3 groups based on age. The younger age group included patients 40 years of age and younger, the older group included patients over 80 years of age, and the remaining patients served as the control group. Descriptive statistics were used to summarize study data. Nonparametric quantitative and qualitative analyses were performed using the Mann-Whitney U test and Fisher's exact test, respectively. Survival analysis was performed using the generalized Wilcoxon test. The Cox proportional hazards model was used for multivariate analysis.

Results: Of the 209 patients with laryngeal carcinoma presenting to our institution over a 9-year period, 20 (10%) were < or =40 years and 15 (7%) were > or =80 years of age. No differences in TNM stage at presentation, treatment, or treatment-associated complications were observed based on age. However, younger patients were less likely to report tobacco (50%; P < .001) or alcohol (57%; P = .03) use and more likely to have human immunodeficiency virus infection (50%; P< .001). Older patients showed a trend toward having a worse baseline medical status. Recurrence was significantly more common in older patients (P = .02) and cause-specific survival significantly poorer for both younger and older patients (P = .002).

Conclusions: The presentation and outcome of laryngeal cancer is influenced by the age at presentation. The differences may be related exact reason for the observed survival differences needs to be determined.