Comparative Survival Outcomes Of Different Treatments For Oral Tongue Squamous Cell Carcinoma In Elderly Patients Aged 65 Years And Older: A Propensity Score Matched Analysis

Background: The recommended treatments for elderly patients aged 65 years and older with oral tongue squamous cell carcinoma (OTSCC) are ambiguous. The aim of this study is to explore the optimized treatments for the elderly OTSCC patients based on the Surveillance, Epidemiology, and End Results database. Materials and Methods: We retrospectively divided patients into four groups, including both surgery and adjuvant radiation, surgery only, radiation only, and neither surgery nor radiation. Overall survival (OS) and tumor cause-specific survival (TCSS) were evaluated. Kaplan-Meier analysis and Cox regression analysis were adopted to distinguish independent risk factors for OS and TCSS. Results: We identified 1,355 patients aged 65 years and older with OTSCC after propensity score matching. No statistically significant differences were detected for baseline data. Treatment was demonstrated to be an independent prognostic factor for OS and TCSS. The 5-year OS rates were 37.7%, 47.6%, 33.1% and 10.9% in the four groups, and the corresponding 5-year TCSS rates were 70.3%, 67.5%, 68.3% and 60.3%. Generally, no statistically significant differences were detected among treatments of both surgery and adjuvant radiation, surgery only and radiation only for survival. Receiving no treatment showed poor prognosis for OS and TCSS. Subgroup analysis revealed that surgery only presented benefit of OS for early OTSCC, and for advanced OTSCC, surgery and adjuvant radiation displayed better prognosis outcomes. Conclusion: Surgery may be the recommended treatment strategy in elderly patients with early OTSCC. Radiation is optional for those intolerant to surgery. Surgery and adjuvant radiation could be recommended for advanced OTSCC.