The influence of age on postoperative complications after total laryngectomy or pharyngolaryngectomy.
OBJECTIVE
This study aimed to evaluate the role of age in the occurrence of postoperative complications after total laryngopharyngectomy (TLP) or total laryngectomy (TL).


METHODS
This was a retrospective study including all patients who underwent TLP or TL in our institution between January 2005 and December 2010. The impact of age (greater than 65 years), history of cancer treatments and comorbidities on early postoperative course was analyzed using univariate and multivariate analyses.


RESULTS
Out of the 97 patients operated on, 21% had cancer of the hypopharynx and 79% of the larynx. Mean age at surgery was 63 years (41-90 years). 44% of patients were more than or equal to 65 years of age. Regarding local complications, only age (p = 0.004) had a statistically significant influence in univariate analysis. In multivariate analysis, age (OR 21.4, p = 0.0001) and alcohol consumption (OR 0.18, p = 0.04) were significant. Factors influencing the occurrence of general complications were, in univariate analysis: age >65 years (p = 0.003), type of surgery (p = 0.042), the presence of cardiovascular history (p = 0.47) and ASA score >2 (p = 0.007). In multivariate analysis, only age >65 years remained significant (OR 3.31, p = 0.013).


CONCLUSIONS
Our results highlight the importance of preoperative oncogeriatric evaluation from the age of 65 years to optimize surgical management.
Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385 Marseille Cedex 05, France.
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Lagier
Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385 Marseille Cedex 05, France.
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Mimouni-Benabu
Unité d'Aide Méthodologique à la Recherche Clinique, Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385 Marseille Cedex 05, France; EA 3279 'Qualité de Vie Concepts, Usages et Limites, Déterminants' Aix-Marseille Université, Faculté de Médecine, 27 bd Jean Moulin, 13385 Marseille Cedex 05, France.
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Baumstarck
EA 3279 'Qualité de Vie Concepts, Usages et Limites, Déterminants' Aix-Marseille Université, Faculté de Médecine, 27 bd Jean Moulin, 13385 Marseille Cedex 05, France.
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Boulogne
Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385 Marseille Cedex 05, France.
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Michel
Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385 Marseille Cedex 05, France.
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Benabu
Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385 Marseille Cedex 05, France.
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Dessi
Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385 Marseille Cedex 05, France.
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Giovanni
Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Timone, 264 rue Saint Pierre, 13385 Marseille Cedex 05, France. Electronic address: nicolas.fakhry@ap-hm.fr.
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Fakhry
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010611:Pharyngectomy / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
Cancer; Elderly; Geriatric; Head and neck; Larynx