Oral Cancer In the Elderly Population: A Retrospective Observational Study in a Sample of 386 Patients

Abstract

 The aim of the present study is to conduct a descriptive epidemiological analysis of clinical and histopathological data related to the treatment of squamous cell carcinoma of the oral cavity in a population of elderly patients. To address the research inquiries, a population of patients diagnosed with oral cancer at the Maxillofacial Unit of Verona University between 1997 and 2017 was considered. To create the descriptive statistics of the sample population, the following parameters were collected: sex, age, site of the tumor, frequency and type of surgical reconstruction, frequency of pathological staging (pTNM), postoperative hospitalization duration, disease recurrence, overall survival, disease-specific survival, and disease-free survival. Three hundred eighty-six patients met the inclusion criteria; the population was divided into two groups: patients aged <75 years and patients aged ≥75 years. The male-to-female ratio in the overall population was 1.41:1. In the entire sample, the primary site of localization of disease was found to be the tongue. A total of 37.3% of patients underwent microvascular flap reconstruction. Reconstruction with a pedicled flap was used in 27.7% of patients under 75 years old and in 11% of patients over 75 years old. Minor reconstructions using local flaps were performed in 14% of cases. Globally, the average length of postoperative hospital stay (LOS) was 15.8 days for patients aged <75 years and 14.5 days for patients aged ≥75 years. Cancer recurrence was registered in 50% of patients under 75 years and 45% of patients over 75 years. Overall survival in patients aged <75 years was 74%, 65,7%, 50.3% at 3, 5, and 10 years, respectively. Overall survival in patients aged ≥75 years was 63.6%, 50.1%, and 23.2% at 3, 5, and 10 years, respectively. The findings of the present study show that squamous cell carcinoma of the oral cavity in patients aged 75 years or older is a relatively frequent pathology that has been increasing in recent decades, likely due to the progressive aging of the general population. The disease is more prevalent in women, who have greater longevity, and in this subgroup, cancer primarily affects the gingiva. Age alone was not found to be a determining factor, whereas the difference observed in overall survival highlights the importance of comorbidities in elderly patients, which must be carefully evaluated and managed before initiating any therapeutic pathway. Finally, the results of this study emphasize the importance of early diagnosis to ensure that patients receive the most appropriate treatment while minimizing invasiveness.