The aim of this study was to analyse the role age and related comorbidities as prognostic factors in patients affected by oral squamous cell carcinoma. We retrospectively studied 165 consecutive patients with histologically confirmed OSCC who had been admitted to one of two surgical units in northern Italy (Department of Oral and Maxillofacial Surgery, S. Orsola-Malpighi University Hospital of Bologna; Department of Maxillofacial Surgery, Bufalini Hospital of Cesena) from September 1998 to January 2009. The patients were affected by primary or recurrent OSCC. The series consisted of 101 males (61.2%) and 64 females (38.8%). The overall mean age was 62.4 years (SD = 14.5; range, 22-95; median = 64.0). The stage of each tumour was determined according to AJCC TNM-classification (9) using the pathological tumour-node-metastasis (pTNM) staging system. The assessment of the patients included examination and diagnostic imaging (CT scan and/or MRI), and only patients without systemic metastases were entered into the study. All patients underwent surgical therapy consisting of radical resection and neck dissection in accordance with standards of treatment quoted in the medical literature. Postoperative radiation therapy was performed in locally advanced T3 and T4 lesions, with high-grade histology or positive or close margins of surgical resection, and in cases with an N-stage higher than N1 (91 patients, 55.2% of the study group). Follow-up was performed every 15 days in the first 2 months after surgery and then every month in the first year after surgery, every 3 months in the second year after surgery, and finally every 6 months until the fifth year after surgery. In the present study we wanted to focus on the role of age in affecting outcome of OSCC patients. Comorbidities are reasonably a prognostic factor for overall survival and that stage is the only prognostic factor that affect tumour-specific survival. Our results appears to confirm what is claimed by the medical letterature. Age is not a prognostic factor for outcome of OSCC patients, if considered alone. Comorbidities must be always included in evaluation of these patients, because they can affect long-term survival, but not purely treatment outcome. In conclusion, our results appear to confirm that elderly patients are eligible for surgical treatment for oral squamous cell carcinoma as much as the younger patients.
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