Craniofacial resections in the elderly: an outcome study.
OBJECTIVE
The elderly population is increasing in number and is healthier now than in the past. The purpose of this study was to examine complications and outcomes following craniofacial resection (CFR) in elderly patients and to compare findings with those of a matched younger cohort.


METHODS
All patients 70 years of age or older undergoing CFR at the M.D. Anderson Cancer Center (elderly group) between December 1992 and July 2003 were identified by examining the Department of Neurosurgery database. A random cohort of 28 patients younger than 70 years of age (control group) was selected from the overall population of patients who underwent CFR. There were 28 patients ranging in age from 70 to 84 years (median 74 years). Major local complications occurred in seven elderly patients (25%) and in six control patients (21%) (p = 0.75), and major systemic complications occurred in nine elderly patients (32%) and in three control patients (11%) (p = 0.05). There was one perioperative death in both groups of patients. The median duration of disease-specific survival for the elderly patients was not reached (mean 6.8 years); however, it was 8.3 years for control patients (p = 0.24). Predictors of poorer overall survival from a multivariate analysis of the elderly group included presence of cardiac disease (p = 0.005), a major systemic perioperative complication (p = 0.03), and a preoperative Karnofsky Performance Scale score less than 100 (p = 0.04).


CONCLUSIONS
In this study of elderly patients who underwent CFR, there was no difference in disease-specific survival when compared with a matched cohort of younger patients. There was, however, an increased incidence of perioperative major systemic complications in the elderly group.
Hentschel
Stephen J
SJ
Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030-4009, USA.
Nader
Remi
R
Suki
Dima
D
Dastgir
Amer
A
Callender
David L
DL
DeMonte
Franco
F
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality* / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery; D018572:Disease-Free Survival; D005153:Facial Neoplasms / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012307:Risk Factors; D019292:Skull Base Neoplasms / Q000401:mortality / Q000601:surgery; D016896:Treatment Outcome