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The objective of this study is to assess prognostic value of surgery for elderly oral tongue squamous cell carcinomas (OTSCC) patients. Patients with OTSCC were extracted from the SEER database between 2010 and 2014. The distributions of categorical demographic and clinicopathological characteristics were determined for different age groups: the 75-79, 80-84, and 85-102 years old groups. Univariate and multivariate analyses were performed to determine the effects of each variable on survival. A total of 1064 patients were analyzed. 75-79 years old patients tended to be male and rate of surgery declined with advancing age (P < 0.001). 75-79 years old patients more frequently presented with advanced stage compared to their older peers (P = 0.002). Compared to surgery groups, the hazard ratios for no surgery groups were 2.856 (95% CI 2.267-3.599; (P < 0.001)) for OS and 3.687 (95% CI 2.561-5.308; (P < 0.001)) for CSS in multivariable analysis. In subgroup analysis, the effect of no surgery was significantly associated with a higher risk of poor CSS in patients aged 75-79 years, 80-84 years and 85-102 years (P < 0.001, respectively). Our results showed that there were a series of factors contributing to poor outcomes in the elderly OTSCC patients, including clinicopathological characteristics and surgical management. Surgical resection is significantly associated with an improved OS and CSS, but further exploration in larger prospective clinical trials and better prognostic and predictive tools for select old patients for surgery are needed.

Background: To analyze the prevalence proportions and prognostic factors of synchronous distant metastases in patients with tonsil squamous cell carcinomas (TSCC)., Methods: TSCC patients were extracted from the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2014. We examined the association between clinical manifestations and distant metastases using Chi-squared tests. Predictors of 5-year survival were assessed using univariate and multivariate analyses., Results: A total of 6193 patients were analyzed and lung was the most common site of distant metastases. Poorly/undifferentiated differentiation was found to be significantly correlated with lung metastasis (p=0.033) and liver and bone metastases were associated with African American (p=0.000 and p=0.000, respectively). A higher T classification was associated with higher prevalence of lung, liver, bone and brain metastasis (p=0.000, p=0.000, p=0.000 and p=0.007, respectively). The same results were found in N classification in lung, liver, and bone metastasis (p=0.000, p=0.000, and p=0.000, respectively). Worse prognosis was associated with older age, Blacks, lower grade, higher T and N classification, no surgery therapy and more metastatic sites., Conclusion: Lung was the most frequent lesion of synchronous distant metastases and liver and bone metastases were associated with African American. Higher T and N classification were independent prognostic parameters for higher prevalence of lung, bone, liver and brain metastasis. Worse prognosis was associated with older age, African Americans, lower grade, higher T and N classification, no surgery therapy and more metastatic sites., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)