Age not a contraindication for microvascular reconstruction of advanced oral cancer

Flap complications continue to be a challenge in microsurgical reconstruction for older adults.They aimed to evaluate the impact of age on surgical outcomes after microvascular reconstruction. They retrospectively investigated 103 patients with oral squamous cell carcinoma who had undergone microvascular reconstruction surgery to compare microsurgical reconstruction, common postoperative complications, and flap success rates in geriatric (>75 years) and non-geriatric (<75 years) patients. We also evaluated differences based on the American Society of Anesthesiologists Physical Status score. They found no significant differences between the geriatric and non-geriatric groups in peri-operative, postoperative, or general complications. Conversely, they found that delirium and aspiration pneumonia were significantly more likely to occur in geriatric patients and that multiple medical complications were significantly more likely to occur in geriatric patients with a high American Society of Anesthesiologists score. Microvascular reconstruction can be performed effectively and without excessive complications in geriatric patients, and age should not be considered a contraindication for this procedure. Comorbidities play a stronger role in the prediction of adverse events. As microvascular reconstruction for advanced oral cancer can be performed effectively and without excessive complications in geriatric patients, age should not be considered a contraindication for this procedure. A patient's ASA PS score, considering the presence of comorbidities, plays a stronger role in predicting the incidence of adverse events.

Reference:

Kouketsu A, Kaneuji T, Yamaguma Y, Yamauchi K, Sugiura T, Takahashi T, Ito H, Yamashita Y. Microvascular reconstruction for oral cancer in older adult patients: the impact of age on surgical outcomes. Oral Surg Oral Med Oral Pathol Oral Radiol. 2024 Jan;137(1):6-11. doi: 10.1016/j.oooo.2023.06.010. Epub 2023 Jun 29. PMID: 37612162.

Keywords:

Age, contraindication, microvascular reconstruction, advanced oral cancer, Kouketsu A, Kaneuji T, Yamaguma Y, Yamauchi K, Sugiura T, Takahashi T, Ito H, Yamashita Y, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology