Oral squamous cell carcinoma (OSCC) diagnoses in elderly patients are expected to double in the next 20 years. Current guidelines suggest surgery as a preferred approach, but elderly patients are hardly considered suitable to challenging surgical treatments. Using a multicentric retrospective analysis, we evaluated the outcomes of 99 patients affected by OSCC and aged at least 70, who underwent to either transoral procedures (TP), open neck resection without (OR) or with reconstruction (ORR). In our cohort, overall survival was significantly hampered by concomitant diseases and postsurgical complications, whose development is driven by the former. Thus, our findings support the growing acceptance that chronological age alone should not be a sufficient contraindication for aggressive surgery in the treatment of OSCC. However, elderly patients affected by OSCC are undoubtedly delicate surgical candidates and accurate selection prior to surgery with curative intent is mandatory.
Oral squamous cell carcinoma (OSCC) diagnoses in elderly patients are expected to double in the next 20 years. Current guidelines suggest surgery as a preferred approach, but elderly patients are hardly considered suitable to challenging surgical treatments. Using a multi-centric retrospective analysis, we evaluated the outcomes of 99 patients affected by OSCC and aged at least 70, who underwent to either transoral procedures (TP), open neck resection without (OR) or with reconstruction (ORR). In our cohort, overall survival was significantly hampered by concomitant diseases and postsurgical complications, whose development is driven by the former. Thus, our findings support the growing acceptance that chronological age alone should not be a sufficient contraindication for aggressive surgery in the treatment of OSCC. However, elderly patients affected by OSCC are undoubtedly delicate surgical candidates and accurate selection prior to surgery with curative intent is mandatory.
Chiarire i fattori di rischio che sottendono la chirurgia del cavo orale e dell’orofaringe negli anziani. RIASSUNTO: Nei prossimi vent’anni è previsto che il numero di diagnosi di carcinoma del cavo orale nel paziente anziano raddoppi. L’approccio chirurgico resta la terapia d’elezione sebbene sia dibattuto se esso possa essere praticabile negli anziani anche nei casi più demolitivi. Attraverso un’analisi retrospettiva multicentrica, abbiamo valutato 99 pazienti ultra-settantenni affetti da carcinoma della cavità orale sottoposti a chirurgia transorale, o resezione open con o senza ricostruzione. Nella nostra coorte, la sopravvivenza dei pazienti è stata negativamente influenzata dalla presenza di comorbidità e dallo sviluppo di complicanze post-operatorie. Inoltre, la comparsa di tali complicanze è stata posta in diretta correlazione con la presenza di una o più patologie concomitanti nel quadro clinico del paziente. Tuttavia, sebbene il paziente anziano sia un candidato delicato per approccio chirurgico ed un’accurata selezione sia quindi necessaria, i nostri risultati suggeriscono che l’età anagrafica non debba essere considerata una controindicazione sufficiente ad escludere a priori pazienti anziani candidati a trattamento chirurgico.
Unravelling the risk factors that underlie oral and oropharyngeal surgery in elderly / Molteni, G; Valerini, S; Alicandri-Ciufelli, M; Sprio Phd, A E; Crosetti, E; Berta, G N; Presutti, L; Succo, G. - In: ACTA OTORHINOLARYNGOLOGICA ITALICA. - ISSN 1827-675X. - 38:4(2018), pp. 409-416. [10.14639/0392-100X-1507]
Unravelling the risk factors that underlie oral and oropharyngeal surgery in elderly
Molteni, G;Valerini, S;Alicandri-Ciufelli, M;Presutti, L;
2018
Abstract
Oral squamous cell carcinoma (OSCC) diagnoses in elderly patients are expected to double in the next 20 years. Current guidelines suggest surgery as a preferred approach, but elderly patients are hardly considered suitable to challenging surgical treatments. Using a multi-centric retrospective analysis, we evaluated the outcomes of 99 patients affected by OSCC and aged at least 70, who underwent to either transoral procedures (TP), open neck resection without (OR) or with reconstruction (ORR). In our cohort, overall survival was significantly hampered by concomitant diseases and postsurgical complications, whose development is driven by the former. Thus, our findings support the growing acceptance that chronological age alone should not be a sufficient contraindication for aggressive surgery in the treatment of OSCC. However, elderly patients affected by OSCC are undoubtedly delicate surgical candidates and accurate selection prior to surgery with curative intent is mandatory.File | Dimensione | Formato | |
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