Clinical characteristics, treatment patterns, and oncological outcomes in patients with squamous cell carcinoma of the head and neck at very advanced age (≥80 years).

INTRODUCTION Population aging has increased the number of patients with head and neck squamous cell carcinoma (HNSCC) who are very elderly (≥80 years). However, patients ≥80 years remain poorly characterized, and their clinical profile and prognosis continue to be a subject of debate. The objective of this study is to specifically analyze the characteristics and oncological outcomes of patients with HNSCC aged ≥80 compared with younger patients.

Materials And Methods

We conducted a retrospective study using a prospective institutional database that included patients diagnosed with HNSCC between 1985 and 2025. Patients were grouped according to age at diagnosis (<70, 70-79, and ≥80 years). Clinical and tumor characteristics, treatment patterns, and survival were evaluated.

Results

Patients aged ≥80 years had a distinct clinical profile, with poorer functional status, a greater comorbidity burden, lower exposure to toxic agents, and less cervical lymph node involvement. Despite a higher proportion of early- stage disease, they showed significantly lower disease-specific survival. With increasing age, there was a progressive shift toward less intensive treatments. Age ≥80 years was independently associated with worse disease-specific survival, although part of this effect was mediated by functional status and comorbidity.

Conclusion

Patients with HNSCC aged ≥80 years constitute a clinically distinct population whose outcomes cannot be extrapolated from younger cohorts, supporting the need for individualized therapeutic strategies based on functional status rather than chronological age.