Major surgery in elderly head and neck cancer patients: immediate and long-term surgical results and complication rates.
BACKGROUND
Evaluation of immediate and long-term surgical results in major surgery for the head and neck tumours in elderly patients and identification of tumour and patient related factors that affect the incidence and severity of surgical and medical complications.


METHODS
Retrospective analysis of a series of 24 consecutive patients aged 70 and over with head and neck tumours undergoing extensive surgical resections with reconstruction with/without osseous and/or soft tissue transfer. Patients' demographics and surgery and tumour related data were extracted from appropriate charts and recorded. Pre-existent comorbid conditions, immediate and long-term surgical and medical complications were analysed. Pre-existing comorbidities were graded and staged using the Comorbidity Data Collection Form. Postoperative surgical and medical complications were scored according to their severity.


RESULTS
Overall complication rate in present study was 63% and 54% of patients experienced clinically important surgical and/or medical complications. However, medium admission time remained at 16 days. Presence of advanced comorbidity, longer operative times and advanced stage of disease seemed to influence the development of surgical or medical complications.


CONCLUSIONS
Major surgery for head and neck tumours is of great value even in elderly patients providing very good surgical results with acceptable complication rates. The choice of treatment modality should be based on all factors affecting the treatment outcomes. In particular, the presence of the co-existent underlying diseases should be assessed meticulously and in cases with clinically important comorbidities the surgical treatment stress should be reduced to minimum.
Zabrodsky
Michal
M
Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy.
Calabrese
Luca
L
Tosoni
Antonella
A
Ansarin
Mohssen
M
Giugliano
Gioacchino
G
Bruschini
Roberto
R
Tradati
Nicoletta
N
De Paoli
Fiora
F
Tredici
Paola
P
Betka
Jan
J
Chiesa
Fausto
F
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome