Geriatric assessment of patients treated for cutaneous head and neck malignancies in a tertiary referral center: Predictors of postoperative complications

Autor: Bernard F. A. M. van der Laan, Suzanne Festen, Julius de Vries, Marloes S. van Kester, Geertruida H. de Bock, Emöke Rácz, Linda Bras, Gyorgy B. Halmos, Boudewijn E. C. Plaat, Anne N. Heirman
Přispěvatelé: Damage and Repair in Cancer Development and Cancer Treatment (DARE), Life Course Epidemiology (LCE), Man, Biomaterials and Microbes (MBM), ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Guided Treatment in Optimal Selected Cancer Patients (GUTS)
Rok vydání: 2020
Předmět:
Male
Skin Neoplasms
Geriatric screening
Comorbidity
Logistic regression
Cognition
Postoperative Complications
0302 clinical medicine
Activities of Daily Living
Epidemiology
EPIDEMIOLOGY
Medicine
Skin malignancy
Prospective Studies
030212 general & internal medicine
ELDERLY-PATIENTS
RISK
Aged
80 and over
education.field_of_study
Frailty
General Medicine
Mental Health
Oncology
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Female
SQUAMOUS-CELL CARCINOMA
medicine.medical_specialty
Population
NONMELANOMA SKIN-CANCER
Head and neck surgery
Nutritional Status
03 medical and health sciences
Social support
Internal medicine
UNIVERSAL SCREENING TOOL
Humans
education
Geriatric Assessment
Aged
OLDER
Polypharmacy
business.industry
MORTALITY
Social Support
Odds ratio
medicine.disease
Confidence interval
DERMATOLOGICAL SURGERY
Surgery
business
Zdroj: European Journal of Surgical Oncology, 46(1), 123-130. ELSEVIER SCI LTD
ISSN: 0748-7983
Popis: Introduction As cutaneous head and neck malignancies are highly prevalent especially in older patients, the risk of surgical complications is substantial in this potentially vulnerable population. The objective of this study was to evaluate the value of geriatric assessment of this population with respect to postoperative complications. Methods Patients were prospectively included in OncoLifeS, a databiobank. Before surgery, patients underwent a geriatric assessment including multiple validated screening tools for frailty, comorbidity, polypharmacy, nutrition, functional status, social support, cognition and psychological status. Postoperatively, complications (Clavien-Dindo ≥ grade II) were registered. Uni- and multivariable logistic regression analyses were performed yielding odds ratios (ORs) and 95% confidence intervals (95%CIs). Results 151 patients undergoing surgery for cutaneous head and neck malignancies were included in this study (mean age 78.9 years, 73.5% male). In a multivariable analysis, frailty measured by the Geriatric 8 (G8) (OR = 6.34; 95%CI:1.73–23.25) was the strongest independent predictor of postoperative complications, among other predictors such as major treatment intensity (OR = 2.73; 95%CI:1.19–6.26) and general anesthesia (OR = 4.74; 95%CI:1.02–22.17), adjusted for age and sex. Conclusion Frailty, measured by G8, is the strongest predictor of postoperative complications in patients undergoing surgery for cutaneous head and neck malignancies in addition to treatment intensity and type of anesthesia. Geriatric screening on multiple domains is recommended for patients with cutaneous malignancies undergoing head and neck surgery is recommended, as this population includes old patients and frequently suffers postoperative complications.
Databáze: OpenAIRE
Externí odkaz: