Increasing Mean Age of Head and Neck Cancer Patients at a German Tertiary Referral Center
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient and Demographic Data
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Bray, F.; Ferlay, J.; Soerjomataram, I.; Siegel, R.L.; Torre, L.A.; Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018. [Google Scholar] [CrossRef] [Green Version]
- van Monsjou, H.S.; Wreesmann, V.B.; van den Brekel, M.W.; Balm, A.J. Head and neck squamous cell carcinoma in young patients. Oral Oncol. 2013, 49, 1097–1102. [Google Scholar] [CrossRef] [PubMed]
- Hoeijmakers, J.H. DNA damage, aging, and cancer. N. Engl. J. Med. 2009, 361, 1475–1485. [Google Scholar] [CrossRef]
- Pison, G. The population of the world. Popul. Sociétés 2019, 503, 1–8. [Google Scholar]
- Smith, B.D.; Smith, G.L.; Hurria, A.; Hortobagyi, G.N.; Buchholz, T.A. Future of cancer incidence in the United States: Burdens upon an aging, changing nation. J. Clin. Oncol. 2009, 27, 2758–2765. [Google Scholar] [CrossRef] [PubMed]
- Eytan, D.F.; Blackford, A.L.; Eisele, D.W.; Fakhry, C. Prevalence of Comorbidities among Older Head and Neck Cancer Survivors in the United States. Otolaryngol. Head Neck Surg. 2019, 160, 85–92. [Google Scholar] [CrossRef] [PubMed]
- Wigand, M.C.; Jeske, S.; Hahn, J.; Doescher, J.; Laban, S.; Hoffmann, T.K.; Schuler, P.J. Oncoimmunology in old age. HNO 2020, 68, 177–183. [Google Scholar] [CrossRef]
- Jeske, S.S.; Schuler, P.J.; Doescher, J.; Theodoraki, M.-N.; Laban, S.; Brunner, C.; Hoffmann, T.K.; Wigand, M. Age-related changes in T lymphocytes of patients with head and neck squamous cell carcinoma. Immun. Ageing 2020, 17, 1–11. [Google Scholar] [CrossRef] [Green Version]
- Stein, A.P.; Saha, S.; Kraninger, J.L.; Swick, A.D.; Yu, M.; Lambert, P.F.; Kimple, R.J. Prevalence of Human Papillomavirus in Oropharyngeal Cancer: A Systematic Review. Cancer J. 2015, 21, 138–146. [Google Scholar] [CrossRef] [Green Version]
- de Martel, C.; Plummer, M.; Vignat, J.; Franceschi, S. Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int. J. Cancer 2017, 141, 664–670. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Van Dyne, E.A.; Henley, S.J.; Saraiya, M.; Thomas, C.C.; Markowitz, L.E.; Benard, V.B. Trends in Human Papillomavirus-Associated Cancers—United States, 1999–2015. Morb. Mortal. Wkly. Rep. 2018, 67, 918–924. [Google Scholar] [CrossRef] [Green Version]
- Smith, E.M.; Ritchie, J.M.; Summersgill, K.F.; Klussmann, J.P.; Lee, J.H.; Wang, D.; Haugen, T.H.; Turek, L.P. Age, sexual behavior and human papillomavirus infection in oral cavity and oropharyngeal cancers. Int. J. Cancer 2004, 108, 766–772. [Google Scholar] [CrossRef]
- Windon, M.J.; D’Souza, G.; Rettig, E.M.; Westra, W.H.; van Zante, A.; Wang, S.J.; Ryan, W.R.; Mydlarz, W.K.; Ha, P.K.; Miles, B.A.; et al. Increasing prevalence of human papillomavirus-positive oropharyngeal cancers among older adults. Cancer 2018, 124, 2993–2999. [Google Scholar] [CrossRef] [Green Version]
- Jacobs, M.V.; de Roda Husman, A.M.; van den Brule, A.J.; Snijders, P.J.; Meijer, C.J.; Walboomers, J.M. Group-specific differentiation between high- and low-risk human papillomavirus genotypes by general primer-mediated PCR and two cocktails of oligonucleotide probes. J. Clin. Microbiol. 1995, 33, 901–905. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Benjamini, Y.; Krieger, A.M.; Yekutieli, D. Adaptive linear step-up procedures that control the false discovery rate. Biometrika 2006, 93, 491–507. [Google Scholar] [CrossRef]
- Cline, B.J.; Simpson, M.C.; Gropler, M.; Bukatko, A.R.; Adjei Boakye, E.; Mohammed, K.A.; Osazuwa-Peters, N. Change in Age at Diagnosis of Oropharyngeal Cancer in the United States, 1975–2016. Cancers 2020, 12, 3191. [Google Scholar] [CrossRef]
- Hussein, A.A.; Helder, M.N.; de Visscher, J.G.; Leemans, C.R.; Braakhuis, B.J.; de Vet, H.C.W.; Forouzanfar, T. Global incidence of oral and oropharynx cancer in patients younger than 45 years versus older patients: A systematic review. Eur. J. Cancer 2017, 82, 115–127. [Google Scholar] [CrossRef]
- Chaturvedi, A.; Engels, E.; Pfeiffer, R.; Hernandez, B.; Xiao, W.; Kim, E.; Jiang, B.; Goodman, M.; Sibug-Saber, M.; Cozen, W. Human papillomavirus (HPV) and rising oropharyngeal cancer incidence and survival in the United States. J. Clin. Oncol. 2011, 29 (Suppl. 15), 5529. [Google Scholar] [CrossRef] [PubMed]
- Poethko-Muller, C.; Buttmann-Schweiger, N. HPV vaccination coverage in German girls: Results of the KiGGS study: First follow-up (KiGGS Wave 1). Bundesgesundheitsblatt Gesundh. Gesundh. 2014, 57, 869–877. [Google Scholar]
- Quante, A.S.; Ming, C.; Rottmann, M.; Engel, J.; Boeck, S.; Heinemann, V.; Westphalen, C.B.; Strauch, K. Projections of cancer incidence and cancer-related deaths in Germany by 2020 and 2030. Cancer Med. 2016, 5, 2649–2656. [Google Scholar] [CrossRef] [PubMed]
- Rettig, E.M.; Zaidi, M.; Faraji, F.; Eisele, D.W.; El Asmar, M.; Fung, N.; D’Souza, G.; Fakhry, C. Oropharyngeal cancer is no longer a disease of younger patients and the prognostic advantage of Human Papillomavirus is attenuated among older patients: Analysis of the National Cancer Database. Oral oncology 2018, 83, 147–153. [Google Scholar] [CrossRef] [PubMed]
- Marengoni, A.; Angleman, S.; Melis, R.; Mangialasche, F.; Karp, A.; Garmen, A.; Meinow, B.; Fratiglioni, L. Aging with multimorbidity: A systematic review of the literature. Ageing Res. Rev. 2011, 10, 430–439. [Google Scholar] [CrossRef] [PubMed]
- Sarini, J.; Fournier, C.; Lefebvre, J.-L.; Bonafos, G.; Van, J.T.; Coche-Dequéant, B. Head and neck squamous cell carcinoma in elderly patients: A long-term retrospective review of 273 cases. Arch. Otolaryngol. Head Neck Surg. 2001, 127, 1089–1092. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Time Period | 2004–2008 | 2009–2013 | 2014–2018 | Total: 2004–2018 | p-Value | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Variable | N | % | Mean Age | N | % | Mean Age | N | % | Mean Age | N | % | Mean Age | ||
Gender | Male | 476 | 83.2 | 60.5 | 582 | 77.8 | 63.1 | 806 | 77.8 | 64.6 | 1944 | 79.3% | 62.9 | 0.781 |
Female | 96 | 16.8 | 62.3 | 166 | 22.2 | 61.9 | 230 | 22.2 | 63.6 | 506 | 20.7% | 62.7 | ||
Total | 572 | 100.0 | 60.8 | 748 | 100.0 | 62.8 | 1036 | 100.0 | 64.4 | 2450 | 100.0% | 62.8 | n.a. | |
Primary site | Oropharynx | 166 | 29.0 | 59.7 | 231 | 30.9 | 61.3 | 342 | 33.0 | 62.8 | 760 | 31.0% | 61.5 | <0.0005 |
Hypopharynx | 107 | 18.7 | 58.5 | 103 | 13.8 | 62.8 | 140 | 13.5 | 64.5 | 372 | 15.2% | 62.1 | ||
Larynx | 147 | 25.7 | 63.7 | 183 | 24.5 | 65.8 | 230 | 22.2 | 67.1 | 570 | 23.3% | 65.7 | ||
Oral Cavity | 66 | 11.5 | 60.8 | 111 | 14.8 | 60.1 | 135 | 13.0 | 64.3 | 350 | 14.3% | 61.7 | ||
Sinunasal | 39 | 6.8 | 61.3 | 56 | 7.5 | 63.8 | 96 | 9.3 | 61.4 | 193 | 7.9% | 62.0 | ||
Nasopharynx | 16 | 2.8 | 55.6 | 23 | 3.1 | 54.9 | 20 | 1.9 | 49.7 | 59 | 2.4% | 53.3 | ||
Salivary Glands | 27 | 4.7 | 65.3 | 37 | 4.9 | 67.5 | 59 | 5.7 | 71.4 | 124 | 5.1% | 68.8 | ||
Lip | 4 | 0.7 | 51.4 | 4 | 0.5 | 75.6 | 10 | 1.0 | 71.5 | 18 | 0.7% | 67.9 | ||
Middle Ear | 0 | 0.0 | 0 | 0 | 4 | 0.4 | 71.1 | 4 | 0.2% | 71.1 | ||||
T-status | cT1/2 | 162 | 28.3 | 62.4 | 274 | 36.6 | 63.2 | 455 | 43.9 | 63.1 | 944 | 38.5% | 62.7 | 0.087 |
cT3/4 | 228 | 39.9 | 60.2 | 300 | 40.1 | 62.6 | 504 | 48.6 | 65.7 | 1052 | 42.9% | 63.5 | ||
missing | 182 | 31.8 | 574 | 76.7 | 77 | 7.4 | 454 | 18.5% | n.a. | |||||
N-status | cN0 | 160 | 28.0 | 64.1 | 217 | 29 | 63.2 | 415 | 40.1 | 66.0 | 830 | 33.9% | 65.3 | <0.0005 |
cN+ | 235 | 41.1 | 59.0 | 342 | 45.7 | 62.6 | 538 | 51.9 | 63.0 | 1143 | 46.7% | 61.3 | ||
missing | 177 | 30.9 | 189 | 25.3 | 83 | 8.0 | 449 | 18.3% | ||||||
Age grouped | <50 | 109 | 19.1 | 43.9 | 86 | 11.5 | 43.9 | 94 | 9.1 | 42.2 | 307 | 12.5% | 43.5 | n.a. |
≥50 < 70 | 342 | 59.8 | 60.7 | 452 | 60.4 | 59.9 | 599 | 57.8 | 60.6 | 1461 | 59.6% | 60.4 | ||
>70 | 121 | 21.2 | 76.4 | 210 | 28.1 | 76.7 | 343 | 33.1 | 77.2 | 682 | 27.8% | 76.9 |
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Vahl, J.M.; Wigand, M.C.; Denkinger, M.; Dallmeier, D.; Steiger, C.; Welke, C.; Kuhn, P.; Idel, C.; Doescher, J.; von Witzleben, A.; et al. Increasing Mean Age of Head and Neck Cancer Patients at a German Tertiary Referral Center. Cancers 2021, 13, 832. https://doi.org/10.3390/cancers13040832
Vahl JM, Wigand MC, Denkinger M, Dallmeier D, Steiger C, Welke C, Kuhn P, Idel C, Doescher J, von Witzleben A, et al. Increasing Mean Age of Head and Neck Cancer Patients at a German Tertiary Referral Center. Cancers. 2021; 13(4):832. https://doi.org/10.3390/cancers13040832
Chicago/Turabian StyleVahl, Julius M., Marlene C. Wigand, Michael Denkinger, Dhayana Dallmeier, Chiara Steiger, Claudia Welke, Peter Kuhn, Christian Idel, Johannes Doescher, Adrian von Witzleben, and et al. 2021. "Increasing Mean Age of Head and Neck Cancer Patients at a German Tertiary Referral Center" Cancers 13, no. 4: 832. https://doi.org/10.3390/cancers13040832