title: Oncological and surgical outcome of total laryngectomy in combination with neck dissection in the elderly.
abstract: There are controversial data on oncological and surgical outcome after major head and neck cancer surgery in the elderly. The aim of this study was to evaluate the outcome of elderly cancer patients after total laryngectomy in combination with neck dissection. A total of 58 patients separated into two age groups (28 < 65 vs. 30 ≥ 65 years) with hypopharyngeal and laryngeal cancer who underwent total laryngectomy and neck dissection were enrolled. Comorbidities of both age groups using the Charlson comorbidity index, hospitalization days as well as surgical complications evaluated by the Clavien-Dindo classification were examined. Overall and disease-free survivals of all patients were analyzed. The average follow-up was 2.9 years. Surgical complication rate was significantly increased in elderly (p = 0.04). However, complications could be treated without surgical intervention in most cases without significant extension of hospitalization. Locoregional and distant control did not significantly differ in both age groups. Disease-free and overall survival showed no significant differences for the two age groups by the Kaplan-Meier analysis (p = 0.66 and 0.08, respectively). Total laryngectomy in combination with neck dissection can be considered in elderly patients with satisfactory oncological and surgical outcome.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Baldingerstr., 35043, Marburg, Germany.
authors.forename: Afshin
authors.initials: A
authors.lastname: Teymoortash
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Baldingerstr., 35043, Marburg, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Bohne
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Baldingerstr., 35043, Marburg, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Kissing
authors.affiliation: Institute of Medical Biometry and Epidemiology, Philipp University, Marburg, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Daniel
authors.affiliation: Department of Cardiology, Philipp University, Marburg, Germany.
authors.forename: Bilgen
authors.initials: B
authors.lastname: Kurt
authors.affiliation: Department of Otolaryngology, Head/Neck and Facial Plastic Surgery, Sana Kliniken Leipziger Land, Borna, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wilhelm
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Groningen, Groningen, Netherlands.
authors.forename: Gyorgy B
authors.initials: GB
authors.lastname: Halmos
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Baldingerstr., 35043, Marburg, Germany. teymoort@med.uni-marburg.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: Hoch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Comorbidity; Complication; Elderly; Laryngectomy; Neck dissection; Survival