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Kristen B. Pytynia, MD; Jonathan R. Grant, MD; Carol J. Etzel, PhD; Dianna Roberts, PhD, MS; Qingyi Wei, MD, PhD; Erich M. Sturgis, MD

Arch Otolaryngol Head Neck Surg. 2004;130:869-873.

Objectives  To compare the survival rates of patients 40 years or younger and diagnosed with squamous cell carcinoma of the head and neck (SCCHN) with those of patients older than 40 years who underwent the same treatment. In 2 previous matched-pair analyses, the patients had been matched for tumor stage, site, sex, and date of presentation but not type of treatment.

Methods  Between 1995 and 2001, 46 patients 40 years or younger participated in a prospective epidemiologic study that included more than 500 patients newly diagnosed with SCCHN. We matched each of these patients by sex, race, tumor site, overall stage, and treatment modality with 2 patients older than 40 years. Ultimately, 31 of the younger patients were matched with 62 of the older patients. Survival analysis was performed using Cox proportional hazard models and accounting for the matched trios.

Results  There was no difference in overall, disease-specific, or recurrence-free survival rates between the patients who were 40 years or younger and those older than 40 years. Furthermore, matched survival analysis did not demonstrate a difference in overall survival rate (risk ratio [RR], 0.71; 95% confidence interval [CI], 0.22-2.29; P = .56), disease-free survival rate (RR, 0.83; 95% CI, 0.20-3.33; P = .79), or time to recurrence (RR, 1.46; 95% CI, 0.50-4.23; P = .49), and was not affected by adjustment for medical comorbidities or the severity of cancer-associated symptoms.

Conclusions  We found no evidence of a difference in the survival rates of patients with SCCHN who were 40 years or younger or older than 40 years and underwent similar treatment at our institution.

From the Departments of Head and Neck Surgery (Drs Pytynia, Grant, Roberts, and Sturgis) and Epidemiology (Drs Etzel, Wei, and Sturgis), The University of Texas M. D. Anderson Cancer Center, Houston. The authors have no relevant financial interest in this article.

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