title: Head and neck cancer surgery in an elderly patient population: a retrospective review.
abstract: Should advanced age be a contraindication to the surgical management of head and neck cancer patients? A retrospective chart review was performed of patients aged ≥80 years treated surgically for a head and neck malignancy during the period 1996-2011 in a tertiary care cancer centre. The average follow-up was 32 months. Fifty-three patients were identified (mean age 85 years). Cardiovascular disease was the most prevalent co-morbidity (43%). Forty-five patients (85%) had oral cavity/oropharynx squamous cell carcinoma. Surgeries performed included 40 neck dissections and 12 microvascular free flaps. The average length of hospital stay (LOS) was 6.4 days. An increased LOS was significant in patients requiring free flap reconstruction (P<0.01). There were no perioperative deaths or free flap failures. The most common postoperative complications were cardiovascular (n=8), infection (n=10), and delirium (n=6). Thirty-four patients were discharged directly home. Free flap reconstruction did not adversely affect discharge disposition (P>0.05). More than 75% of patients did not report any major limitations to their activities of daily living. Major head and neck surgical procedures can be tolerated by patients of advanced age using careful patient selection. Age alone should not be a primary factor in the management of head and neck cancer patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Oncology Program, Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA.
authors.forename: R
authors.initials: R
authors.lastname: Yang
authors.affiliation: Department of Oral and Maxillofacial Surgery, Oncology Program, Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA. Electronic address: jlubek@umaryland.edu.
authors.forename: J E
authors.initials: JE
authors.lastname: Lubek
authors.affiliation: Department of Oral and Maxillofacial Surgery, Oncology Program, Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA.
authors.forename: D
authors.initials: D
authors.lastname: Dyalram
authors.affiliation: Department of Epidemiology and Preventative Medicine, University of Maryland, Baltimore, MD, USA.
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Oral and Maxillofacial Surgery, Oncology Program, Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Ord
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D037981:Neck Dissection; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: elderly; head and neck cancer; surgery