Prognosis of Nasopharyngeal Carcinoma in the Elderly is Worse than in Younger Individuals–Experience of a Medical Institute

Abstract

We aimed to evaluate outcomes of the elderly (>65 years) by comparing with younger (<40 years) patients after treatments for nasopharyngeal carcinoma (NPC). We retrospectively obtained clinical data from charts for 23 older and 21 younger patients in whom NPC was diagnosed and who underwent curative managements during 2007 and 2011. Occurrence of local recurrence, distant metastasis, and death from any cause were recorded as endpoints. Cox proportional hazards regression was applied to determine age effects on survival risks after adjusting for the potential confounders. Older patients more commonly received a diagnosis of chronic diseases than the younger patients (56.5% versus 23.8%, p = 0.036), whereas they were less likely to have received intensive treatments for NPC. After adjusting for medical history and neoadjuvant chemotherapy, older age was the only significant predictor in the study cohort for overall survival and progression-free survival. The adjusted hazard ratio (HR) for death from all causes in older patients was 6.3 (95% confidence interval [CI] = 1.3–30.2), and the adjusted HR for disease progression in older patients was 10.9 (95% CI = 2.3–50.6). Aging was the only independent prognostic risk factor in this study cohort. Medical history and treatment variations could not fully explain the difference in prognosis. Our results strengthen the need to ameliorate toxicities and improve supportive care for older patients with a diagnosis of NPC.