Predictive factors for complications in elderly patients who underwent head and neck oncologic surgery

Sanábria, Álvaro; Carvalho, André L.; Melo, Rosana Leite de; Magrin, José; Ikeda, Mauro Kasuo; Vartanian, José Guilherme; Kowalski, Luiz Paulo

doi:10.1002/hed.20671

Cited by 71 publications

(62 citation statements)

References 29 publications

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“…In other studies [18,[25][26][27][28] mean time of restoration a normal feeding was 25 days and in Pellini's study was in less than 1 month for 61.5 % of patients [22]. The time of removal of the feeding tube ranged in literature from 10-96 days [28] to 12-90 days [18], in our study was 4-230 days.…”

Section: Complications and Functional Resultssupporting

confidence: 38%

Surgical options in radiotherapy-failed early glottic cancer

Santoro

Meccariello

Mannelli

et al. 2013

Eur Arch Otorhinolaryngol

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After failure of curative radiotherapy (RT), surgery is the main therapeutic option to control recurrent laryngeal cancer. Recurrences after RT for T1-T2 tumours of the glottic larynx are often diagnosed at a more severe stage than the original disease and, thus, usually treated by radical approaches. Our aim is to investigate the feasibility of more conservative strategies for proper treatment of post-RT recurred glottic cancer. We collected and reviewed our files from 1990 to 2006, selecting 75 patients which matched the following inclusion criteria: (1) patient was originally diagnosed with early stage squamous cell carcinoma of the glottic larynx (stage I-II according to 2010 TNM), (2) patient was treated by RT with curative intent, (3) patient presented a recurrence of disease after RT which was surgically treated at our Institution. T stage at first diagnosis was T1a in 41 cases (55 %), T1b in 12 (16 %) and T2 in 22 (29 %). At clinical examination of RT-recurred lesions, we documented advanced lesions (rT3-rT4) in 29 out of 75 patients (39 %). Overall, an upstage was reported for 56 % RT-recurred cancers, while 37.3 % remained at the same stage than the original tumour and 6.7 % were downstaged. Twelve patients (16 %) underwent salvage partial laryngectomy (SPL), while 63 (84 %) received a salvage total laryngectomy (STL). Multivariate analysis showed that rTNM according to the AJCC-UICC of 2010 was the only prognostic factor for both disease-free survival (p = 0.042) and overall survival (p = 0.004). Considering the prognostic impact of rT and rN we documented a statistical significance only in terms of overall survival for both factors (p = 0.004 and p = 0.04, respectively). Although STL remains the most frequent treatment choice for failures after RT in laryngeal carcinomas, SPL represents a valid option for selected patients with limited recurrence and can deliver good oncologic and functional results if performed according to careful indications.

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Section: Complications and Functional Resultssupporting

confidence: 38%

Surgical options in radiotherapy-failed early glottic cancer

Santoro

Meccariello

Mannelli

et al. 2013

Eur Arch Otorhinolaryngol

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“…Several recent studies have shown that the benefits of definitive treatment strategies extend to even the oldest oncology patients. Much of the prior research has focused upon the implications for older women with breast cancer [21][22][23], but also across a variety of different cancer diagnoses [24][25][26]. This improvement in outcomes, including survival rates, social and role functioning, and overall quality of life, is observed even among individuals with numerous other medical comorbidities [27].…”

Section: Discussionmentioning

confidence: 98%

Cancer rates, medical comorbidities, and treatment modalities in the oldest patients

Zeber¹,

Copeland²,

Hosek³

et al. 2008

Critical Reviews in Oncology/Hematology

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“…partial resection, total thyroidectomy or therapeutic lymphadenectomy) the better the results in terms of survival [1,16,17]. On the one hand, it is unquestionable that the risk from surgery in geriatric patients is greater than in non-geriatric patients in virtue of the fact that there are more frequent co-morbidities with a subsequent increase in complications of a general nature [18,19]. On the other hand, several studies have demonstrated that the number of complications specifically linked to thyroid surgery in geriatric patients is essentially superimposable on those of younger patients [11e13,20]: in consideration of the nature of the pathologies examined, this may justify more aggressive surgical approaches or at the very least not more restricted compared to those set down for younger patients.…”

Section: Discussionmentioning

confidence: 99%

Cancer of the thyroid gland in geriatric age: A single center retrospective study with a 10-year post-operative follow-up

Santangelo

Giudice

Gallucci

et al. 2014

International Journal of Surgery

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Predictive factors for complications in elderly patients who underwent head and neck oncologic surgery

Abstract: It is possible to predict postoperative complications in older patients with head and neck tumors who underwent oncologic surgery using clinical preoperative variables.

Cited by 71 publications

References 29 publications

Surgical options in radiotherapy-failed early glottic cancer

Surgical options in radiotherapy-failed early glottic cancer

Cancer rates, medical comorbidities, and treatment modalities in the oldest patients

Cancer of the thyroid gland in geriatric age: A single center retrospective study with a 10-year post-operative follow-up

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