Major head and neck surgery in elderly safe with lower complication rate: Study

The study is published in the European Journal of Surgical Oncology.

Evaluation of immediate and long-term surgical results in major surgery for the head and neck tumours in elderly patients and identification of tumour and patient related factors that affect the incidence and severity of surgical and medical complications needs to be done.

Hence, Sharon Tzelnick and colleagues from the Department of Otorhinolaryngology - Head and Neck Surgery, Rabin Medical Center – Beilinson Hospital, Israel carried out the present study with the aim to investigate complication rates in elderly cancer patients undergoing major head and neck surgeries.

The authors conducted a retrospective, matched-control, analysis. For each elderly (≥70 years) patient, a younger, (<70 years) patients were matched based on sex, tumor location, disease stage, and operation time. Post-operative complication and survival analyses were performed.

The following key findings were highlighted-

3. Of 225 patients, 75 (33.3%) were elderly (mean age 76.2 (70–88) years) and compared with a match control group (53.2 (23–69) years).
4. A higher rate of cardio-vascular comorbidity was noted in the elderly group (70.6% vs. 34%, respectively, P < 0.001).
5. The majority (62.7%) of elderly patients required reconstruction with 24% receiving vascularized flap reconstruction.
6. Total postoperative complication rate was 49.9% in the study versus 42.3% in the control group, with a major complication rate of 22.5% in the elderly versus 11.9% in the control group (P = 0.154).
7. Mean follow-up was 41 (0–144) months.
8. Five-year disease-specific (67.1% vs. 80.7%, P < 0.001) and overall survival rates (48.6% vs. 75.4%, P < 0.001) were significantly lower among elderly patients.

Therefore, the authors concluded that "major head and neck surgery in the elderly population does not entail higher complication rate, compared with younger patients, and should be allowed when curative intent is feasible and patient's general condition allows."