Evaluation of the Relationship between Age and Outcome after Microvascular Reconstruction among Patients with Recurrent Head and Neck Squamous Cell Carcinoma

Viraj M. Patel, Carrie Stern, Amar Miglani, Katie E. Weichman, Juan Lin, Thomas J. Ow, Evan S. Garfein

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3 Citations (Scopus)

Abstract

Background In patients with head and neck squamous cell carcinoma (HNSCC), disease recurrence remains a significant obstacle to long-term survival. If possible, surgical salvage with reconstruction remains the best treatment option for patients with recurrence. Currently, there is no literature discussing whether age should preclude microvascular reconstruction in these patients. We hypothesize that older age alone does not affect outcomes. Methods A retrospective chart review of patients with HNSCC at our institution between 2008 and 2015 was performed. Patients were included if they underwent simultaneous resection and flap reconstruction for recurrent HNSCC. Data collected included age, sex, primary site, type of reconstruction, previous treatments, postoperative complications (systemic and reconstructive), and overall survival. Results A total of 65 patients met inclusion criteria for the review: 42 (64.6%) patients ≤70 years and 23 (35.4%) patients > 70 years. Overall survival was not significantly different between the younger and older groups (p = 0.199). Five-year survival was 60.1% in the younger group and 46.8% in the older group. No significant difference was found in reconstructive complication rates (p = 0.179) or systemic complication rates (p = 0.241) between the two groups. Multivariate logistic regression analysis further showed no significant association between patients' age (≤70 years or > 70 years) and reconstructive complications (p = 0.396) or systemic complications (p = 0.119). Conclusion Age is not significantly associated with complications among patients undergoing resection and reconstruction for recurrent HNSCC. Microvascular reconstruction remains a feasible option in older patients with recurrent HNSCC. Advanced age alone should not preclude the surgical management of recurrent HNSCC.

Original languageEnglish (US)
JournalJournal of Reconstructive Microsurgery
DOIs
StateAccepted/In press - Dec 26 2016

Fingerprint

Survival
Carcinoma, squamous cell of head and neck
Recurrence
Logistic Models
Regression Analysis
Therapeutics

Keywords

  • free tissue flaps
  • head and neck cancer
  • life expectancy
  • microsurgical free flaps
  • palliative surgery
  • reconstructive surgical procedures
  • squamous cell carcinoma of the head and neck

ASJC Scopus subject areas

  • Surgery

Cite this

@article{8a1f685f1d9248aeae0eea86a6204c65,
title = "Evaluation of the Relationship between Age and Outcome after Microvascular Reconstruction among Patients with Recurrent Head and Neck Squamous Cell Carcinoma",
abstract = "Background In patients with head and neck squamous cell carcinoma (HNSCC), disease recurrence remains a significant obstacle to long-term survival. If possible, surgical salvage with reconstruction remains the best treatment option for patients with recurrence. Currently, there is no literature discussing whether age should preclude microvascular reconstruction in these patients. We hypothesize that older age alone does not affect outcomes. Methods A retrospective chart review of patients with HNSCC at our institution between 2008 and 2015 was performed. Patients were included if they underwent simultaneous resection and flap reconstruction for recurrent HNSCC. Data collected included age, sex, primary site, type of reconstruction, previous treatments, postoperative complications (systemic and reconstructive), and overall survival. Results A total of 65 patients met inclusion criteria for the review: 42 (64.6{\%}) patients ≤70 years and 23 (35.4{\%}) patients > 70 years. Overall survival was not significantly different between the younger and older groups (p = 0.199). Five-year survival was 60.1{\%} in the younger group and 46.8{\%} in the older group. No significant difference was found in reconstructive complication rates (p = 0.179) or systemic complication rates (p = 0.241) between the two groups. Multivariate logistic regression analysis further showed no significant association between patients' age (≤70 years or > 70 years) and reconstructive complications (p = 0.396) or systemic complications (p = 0.119). Conclusion Age is not significantly associated with complications among patients undergoing resection and reconstruction for recurrent HNSCC. Microvascular reconstruction remains a feasible option in older patients with recurrent HNSCC. Advanced age alone should not preclude the surgical management of recurrent HNSCC.",
keywords = "free tissue flaps, head and neck cancer, life expectancy, microsurgical free flaps, palliative surgery, reconstructive surgical procedures, squamous cell carcinoma of the head and neck",
author = "Patel, {Viraj M.} and Carrie Stern and Amar Miglani and Weichman, {Katie E.} and Juan Lin and Ow, {Thomas J.} and Garfein, {Evan S.}",
year = "2016",
month = "12",
day = "26",
doi = "10.1055/s-0037-1598621",
language = "English (US)",
journal = "Journal of Reconstructive Microsurgery",
issn = "0743-684X",
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}

TY - JOUR

T1 - Evaluation of the Relationship between Age and Outcome after Microvascular Reconstruction among Patients with Recurrent Head and Neck Squamous Cell Carcinoma

AU - Patel, Viraj M.

AU - Stern, Carrie

AU - Miglani, Amar

AU - Weichman, Katie E.

AU - Lin, Juan

AU - Ow, Thomas J.

AU - Garfein, Evan S.

PY - 2016/12/26

Y1 - 2016/12/26

N2 - Background In patients with head and neck squamous cell carcinoma (HNSCC), disease recurrence remains a significant obstacle to long-term survival. If possible, surgical salvage with reconstruction remains the best treatment option for patients with recurrence. Currently, there is no literature discussing whether age should preclude microvascular reconstruction in these patients. We hypothesize that older age alone does not affect outcomes. Methods A retrospective chart review of patients with HNSCC at our institution between 2008 and 2015 was performed. Patients were included if they underwent simultaneous resection and flap reconstruction for recurrent HNSCC. Data collected included age, sex, primary site, type of reconstruction, previous treatments, postoperative complications (systemic and reconstructive), and overall survival. Results A total of 65 patients met inclusion criteria for the review: 42 (64.6%) patients ≤70 years and 23 (35.4%) patients > 70 years. Overall survival was not significantly different between the younger and older groups (p = 0.199). Five-year survival was 60.1% in the younger group and 46.8% in the older group. No significant difference was found in reconstructive complication rates (p = 0.179) or systemic complication rates (p = 0.241) between the two groups. Multivariate logistic regression analysis further showed no significant association between patients' age (≤70 years or > 70 years) and reconstructive complications (p = 0.396) or systemic complications (p = 0.119). Conclusion Age is not significantly associated with complications among patients undergoing resection and reconstruction for recurrent HNSCC. Microvascular reconstruction remains a feasible option in older patients with recurrent HNSCC. Advanced age alone should not preclude the surgical management of recurrent HNSCC.

AB - Background In patients with head and neck squamous cell carcinoma (HNSCC), disease recurrence remains a significant obstacle to long-term survival. If possible, surgical salvage with reconstruction remains the best treatment option for patients with recurrence. Currently, there is no literature discussing whether age should preclude microvascular reconstruction in these patients. We hypothesize that older age alone does not affect outcomes. Methods A retrospective chart review of patients with HNSCC at our institution between 2008 and 2015 was performed. Patients were included if they underwent simultaneous resection and flap reconstruction for recurrent HNSCC. Data collected included age, sex, primary site, type of reconstruction, previous treatments, postoperative complications (systemic and reconstructive), and overall survival. Results A total of 65 patients met inclusion criteria for the review: 42 (64.6%) patients ≤70 years and 23 (35.4%) patients > 70 years. Overall survival was not significantly different between the younger and older groups (p = 0.199). Five-year survival was 60.1% in the younger group and 46.8% in the older group. No significant difference was found in reconstructive complication rates (p = 0.179) or systemic complication rates (p = 0.241) between the two groups. Multivariate logistic regression analysis further showed no significant association between patients' age (≤70 years or > 70 years) and reconstructive complications (p = 0.396) or systemic complications (p = 0.119). Conclusion Age is not significantly associated with complications among patients undergoing resection and reconstruction for recurrent HNSCC. Microvascular reconstruction remains a feasible option in older patients with recurrent HNSCC. Advanced age alone should not preclude the surgical management of recurrent HNSCC.

KW - free tissue flaps

KW - head and neck cancer

KW - life expectancy

KW - microsurgical free flaps

KW - palliative surgery

KW - reconstructive surgical procedures

KW - squamous cell carcinoma of the head and neck

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U2 - 10.1055/s-0037-1598621

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