940P Analysis of a cohort of elderly patients (p) with head and neck cancer (HNC) managed within a multidisciplinary head and neck cancer unit (HNCU)

Abstract

HNC is the sixth most common cancer worldwide. Approximately 25% of HNC p are aged 70 and older and 70% of deaths occur in this group of p. Moreover, advanced age seems to be an independent prognostic factor. We aimed to assess the characteristics and outcome of a cohort of elderly p with HNC treated in a multidisciplinary unit. We retrospectively analysed 151 p diagnosed of HNC and assessed in our HNCU during 2019 in order to evaluate the characteristics of 75 year old p or older (elderly p) and compare them with those of p younger than 75 years. All demographic, treatment and survival data were extracted from available electronic medical records. 41 p (27%) were elderly p. When analyzing the characteristics of the p in this elderly group compared to younger p, we found a higher percentage of women (34% vs. 18%; p=0.037), lower smoking (60 % vs. 90%; p=0.0001) and alcohol abuse (44 % vs. 63%; p=0.038), as well as a worse performance status (p=0.001). Regarding tumour characteristics, elderly p had higher percentage of oral cavity tumours (42% vs. 22%) and fewer oropharyngeal tumours (7% vs. 27%). In the younger group of p, a 30% of oropharyngeal tumours were p16 positive vs. 40% (2/5) in the elderly p group. There were no significant differences in the stage at diagnosis. Considering the first therapeutic management, the most common treatment was surgery (76% vs. 62% in elderly and younger group, respectively), induction chemotherapy or concurrent radiochemotherapy were more significantly used in the younger group (14% vs. 2 % and 16 vs. 5%, respectively) and 17% of elderly p received best supportive care vs. 4% of younger p (p=0.006). Despite short follow-up, 27% of elderly patients were dead at the time of analysis, compared to 16% of younger patients. Almost half of the p in both groups died from causes unrelated to tumour progression (comorbidities, treatment related or unknown). Our analysis suggests that elderly p with HNC have different characteristics and management compared to younger p. Multidisciplinary and geriatric assessment could enhance the optimization of the therapeutic approach.