European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2021
Major head and neck surgeries in the elderly population, a match-control study.
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Tzelnick Sharon, Mizrachi Aviram, Shavit Sagit Stern, Ben-Ner Daniel, Reuven Yonathan, Elias Bshara, Shpitzer Thomas, Bachar Gideon
Аннотация
BACKGROUND AND OBJECTIVES: To investigate complication rates in elderly cancer patients undergoing major head and neck surgeries.
METHODS: A retrospective, matched-control, analysis. For each elderly (≥70 years) patient, a younger, (<70 years) patients were matched based on sex, tumor location, disease stage, and operation time. Post-operative complication and survival analyses were performed.
RESULTS: Of 225 patients, 75 (33.3%) were elderly (mean age 76.2 (70-88) years) and compared with a match control group (53.2 (23-69) years). A higher rate of cardio-vascular comorbidity was noted in the elderly group (70.6% vs. 34%, respectively, P < 0.001). The majority (62.7%) of elderly patients required reconstruction with 24% receiving vascularized flap reconstruction. Total postoperative complication rate was 49.9% in the study versus 42.3% in the control group, with a major complication rate of 22.5% in the elderly versus 11.9% in the control group (P = 0.154). Mean follow-up was 41 (0-144) months. Five-year disease-specific (67.1% vs. 80.7%, P < 0.001) and overall survival rates (48.6% vs. 75.4%, P < 0.001) were significantly lower among elderly patients.
CONCLUSIONS: Major head and neck surgery in the elderly population does not entail higher complication rate, compared with younger patients, and should be allowed when curative intent is feasible and patient's general condition allows.
METHODS: A retrospective, matched-control, analysis. For each elderly (≥70 years) patient, a younger, (<70 years) patients were matched based on sex, tumor location, disease stage, and operation time. Post-operative complication and survival analyses were performed.
RESULTS: Of 225 patients, 75 (33.3%) were elderly (mean age 76.2 (70-88) years) and compared with a match control group (53.2 (23-69) years). A higher rate of cardio-vascular comorbidity was noted in the elderly group (70.6% vs. 34%, respectively, P < 0.001). The majority (62.7%) of elderly patients required reconstruction with 24% receiving vascularized flap reconstruction. Total postoperative complication rate was 49.9% in the study versus 42.3% in the control group, with a major complication rate of 22.5% in the elderly versus 11.9% in the control group (P = 0.154). Mean follow-up was 41 (0-144) months. Five-year disease-specific (67.1% vs. 80.7%, P < 0.001) and overall survival rates (48.6% vs. 75.4%, P < 0.001) were significantly lower among elderly patients.
CONCLUSIONS: Major head and neck surgery in the elderly population does not entail higher complication rate, compared with younger patients, and should be allowed when curative intent is feasible and patient's general condition allows.
Предметные рубрики MeSH
AdultAge FactorsAgedAged, 80 and overArrhythmias, CardiacCase-Control StudiesComorbidityCutaneous FistulaDisease-Free SurvivalFemaleHead and Neck NeoplasmsHumansIschemiaLaryngeal NeoplasmsLaryngectomyMaleMiddle AgedMortalityMouth NeoplasmsNeck DissectionOtorhinolaryngologic Surgical ProceduresPharyngeal DiseasesPleural EffusionPneumoniaPostoperative ComplicationsPulmonary EmbolismPlastic Surgery ProceduresSalvage TherapySepsisSurgical FlapsSurgical Wound InfectionVenous ThrombosisYoung Adult