Clinical Factors 1041

There is controversy regarding the influence of the patient's age at diagnosis and the risk of disease progression to regional lymph nodes. In patients <50 years old, the percentage of lymph node metastases is 39-58%, which is similar to the rate of 48-52% in patients >50 years old.20-22 In 1996 Lopes et al. reported significantly different 5-year survival rates among patients <40, 41-60, and >60 years old of 64.5%, 59.6%, and 38.4%, respectively (p = 0.05).23 More recently, the same group have observed significant differences in univariate analysis between patients <50 and >50 years old, namely 61% and 41%, respectively (p = 0.002).20 In contrast, Lont et al. have reported 5-year survival rates of 78% in patients <60 and 85% in those >60 years old (p = 0.28).24 Recent data have demonstrated that age is an independent predictor of overall survival (HR 2.3-95% CI 1.0-5.1), as well as the presence of lymph node metastases (HR 3.2-95% CI 1.8-5.6) and pathological stage of the primary tumor (HR 1.9 - 95% CI 1.0-3.6).25

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