title: Evaluation of the Relationship between Age and Outcome after Microvascular Reconstruction among Patients with Recurrent Head and Neck Squamous Cell Carcinoma.
abstract: BackgroundIn patients with head and neck squamous cell carcinoma (HNSCC), disease recurrence remains a significant obstacle to long-term survival. If possible, surgical salvage with reconstruction remains the best treatment option for patients with recurrence. Currently, there is no literature discussing whether age should preclude microvascular reconstruction in these patients. We hypothesize that older age alone does not affect outcomes.MethodsA retrospective chart review of patients with HNSCC at our institution between 2008 and 2015 was performed. Patients were included if they underwent simultaneous resection and flap reconstruction for recurrent HNSCC. Data collected included age, sex, primary site, type of reconstruction, previous treatments, postoperative complications (systemic and reconstructive), and overall survival.ResultsA total of 65 patients met inclusion criteria for the review: 42 (64.6%) patients ≤70 years and 23 (35.4%) patients > 70 years. Overall survival was not significantly different between the younger and older groups (p= 0.199). Five-year survival was 60.1% in the younger group and 46.8% in the older group. No significant difference was found in reconstructive complication rates (p= 0.179) or systemic complication rates (p= 0.241) between the two groups. Multivariate logistic regression analysis further showed no significant association between patients' age (≤70 years or > 70 years) and reconstructive complications (p= 0.396) or systemic complications (p= 0.119).ConclusionAge is not significantly associated with complications among patients undergoing resection and reconstruction for recurrent HNSCC. Microvascular reconstruction remains a feasible option in older patients with recurrent HNSCC. Advanced age alone should not preclude the surgical management of recurrent HNSCC.
authors.affiliation: Division of Plastic and Reconstructive Surgery, The Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Viraj M
authors.initials: VM
authors.lastname: Patel
authors.affiliation: Division of Plastic and Reconstructive Surgery, The Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Carrie
authors.initials: C
authors.lastname: Stern
authors.affiliation: Division of Plastic and Reconstructive Surgery, The Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Amar
authors.initials: A
authors.lastname: Miglani
authors.affiliation: Division of Plastic and Reconstructive Surgery, The Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Katie E
authors.initials: KE
authors.lastname: Weichman
authors.affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Juan
authors.initials: J
authors.lastname: Lin
authors.affiliation: The Department Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.|The Department Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Ow
authors.affiliation: Division of Plastic and Reconstructive Surgery, The Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.|The Department Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Evan S
authors.initials: ES
authors.lastname: Garfein
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate