Outcome differences in younger and older patients with laryngeal cancer: Aretrospective case-control study

Purpose: Younger or older age has a significant impact on the outcome of pa tients with head and neck cancer. However, the data regarding outcomes base d on age are conflicting. The aim of this article is to determine the impac t of age on the outcome of laryngeal cancer. Materials and Methods: A retrospective study was performed including all pa tients 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 year s of age, and the remaining patients served as the control group. Descripti ve 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 th e generalized Wilcoxon test. The Cox proportional hazards model was used fo r multivariate analysis. Results: Of the 209 patients with laryngeal carcinoma presenting to our ins titution over a g-year period, 20 (10%) were less than or equal to 40 years and 15 (7%) were greater than or equal to 80 years of age. No differences in TNM stage at presentation, treatment, or treatment-associated complicati ons 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 li kely to have human immunodeficiency virus infection (50%; P < .001). Older patients showed a trend toward having a worse baseline medical status. Recu rrence 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 fo r the observed survival differences needs to be determined. Copyright (C) 2 000 by W.B. Saunders Company.