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Review
. 2022 Apr 8;14(8):1886.
doi: 10.3390/cancers14081886.

Are Survival Outcomes Different for Young and Old Patients with Oral and Oropharyngeal Squamous Cell Carcinoma? A Systematic Review and Meta-Analysis

Swagatika Panda  1 , Neeta Mohanty  1 , Saurav Panda  2 , Lora Mishra  3 , Divya Gopinath  4   5 , Alkananda Sahoo  1 , Sumanth Kumbargere Nagraj  6 , Barbara Lapinska  7
Affiliations
Review

Are Survival Outcomes Different for Young and Old Patients with Oral and Oropharyngeal Squamous Cell Carcinoma? A Systematic Review and Meta-Analysis

Swagatika Panda et al. Cancers (Basel). .

Abstract

This systematic review and meta-analysis aims to address whether age can be a determinant of overall survival (OS), disease-free survival (DFS), recurrence, distant metastasis (DM) and second primary (SP) in surgically treated oral and oropharyngeal squamous cell carcinoma (OOPSCC). A total of 4981 cases and 44254 controls from 25 comparative observational studies were included in the analysis. A significantly better OS (matched subgroup analysis: OR 1.64; 95% CI 1.31-2.04, overall analysis: OR 1.48; 95% CI 1.09-2.01) was observed in young patients compared to older adults, with heterogeneity ranging from moderate to severe. Worse DFS (unmatched subgroup analysis OR 0.43; 95% CI 0.27-0.68) was observed in young patients compared to older adults with minimal to moderate heterogeneity. The frequency of recurrence (OR 1.49; 95% CI 1.10-2.02) and DM (OR 1.83; 95% CI 1.10-3.03) was significantly higher in the young patients, as found in unmatched and matched subgroup analysis, with the least heterogeneities. Young age can be considered as an independent prognostic factor for recurrence and distant metastases in OOP-SCC. Larger and methodologically robust observational studies with longer follow-up are needed to establish the definitive role of age as an independent prognostic factor on OS and DFS in OOPSCC.

Keywords: disease-free survival; distant metastasis; oral carcinoma; oropharyngeal squamous cell carcinoma; overall survival; recurrence; second primary; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Funnel plot of overall survival.
Figure A2
Figure A2
Funnel plot of disease-free survival.
Figure A3
Figure A3
Funnel plot of recurrence.
Figure A4
Figure A4
Funnel plot of distant metastasis.
Figure A5
Figure A5
Funnel plot of second primary.
Figure 1
Figure 1
Prisma flow chart demonstrating the selection of studies.
Figure 2
Figure 2
Risk of bias.
Figure 3
Figure 3
Forest plot demonstrating the OR for overall survival in young patients.
Figure 4
Figure 4
Forest plot demonstrating the OR for DFS in young patients.
Figure 5
Figure 5
Forest plot demonstrating the OR for events of recurrence in young patients.
Figure 6
Figure 6
Forest plot demonstrating the OR for distant metastasis in young patients.
Figure 7
Figure 7
Forest plot demonstrating the OR for the second primary in young patients.
See this image and copyright information in PMC

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