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Cancer of the oral cavity is one of the most common malignancies. There are an estimated , new cases of oral cavity cancer, and more than , oral cavity cancer-related deaths annually 1. Surgery remains the primary standard of care in oral cavity cancer. The survival rate has been raised with the improvements in surgical techniques in combination with adjuvant radiation or chemoradiation therapy 2.

A multidisciplinary approach ensures maximum disease control and minimal side effects 3. Adjuvant systemic therapy and radiotherapy is prescribed based on the independent risk of disease. Overall, Elderly patients aged above 70 years are prone to toxicities in oncologic therapies and non-cancer related death. Standard therapies might be considered relatively aggressive to them and thus not be applied as often as to the younger cohort, considering performance status and tolerance of toxicity 5 , 6.

Although Taiwanese oncologists typically follow the National Comprehensive Cancer Network NCCN guidelines, the limited inclusion of the older population in clinical trials and the associated comorbidities preclude a uniform consensus regarding the optimal management 7.

In elderly patients with early-stage oral cavity squamous cell carcinomas OCSCC , there is yet no clear indication of adjuvant treatment. As the life expectancy of the general population and the number of older patients increases, recognizing the predictors of outcome would allow clinicians to better assess the necessity of adjuvant treatment in these patients 8 , 9.