|Tipo di tesi||Tesi di dottorato di ricerca|
|Titolo||Chirurgia oncologica nel paziente anziano affetto da tumori cervico-facciali. Quando è raccomandabile?|
|Titolo in inglese||Oncologic surgery in elderly head and neck cancer patients. Shall we operate?|
|Settore scientifico disciplinare||MED/31 - OTORINOLARINGOIATRIA|
|Corso di studi||Scuola di D.R. in CLINICAL AND EXPERIMENTAL MEDICINE (CEM) - MEDICINA CLINICA E SPERIMENTALE|
|Data inizio appello||2015-02-05|
|Disponibilità||Accessibile via web (tutti i file della tesi sono accessibili)|
Background Head and neck cancer is rising around the world and is more common after the 6° decade. Considering that expectancy of life is becoming higher, elderly patients who need a treatment for head and neck cancer are increasing everyday. Treatment options in these patients are often limited due to co-morbidities and the phantom of complications. The aim of our study is to evaluate incidence of complications after head and neck oncologic surgery in elderly patients and to identify pre-operative predictive factors for complications. Materials and Methods We conducted a retrospective cohort multicenter study. 418 patients older than 70 years old who underwent surgery for head and neck cancer at the Department of Head and Neck Surgery of Policlinico in Modena and Martini Hospital in Torino between 2001 and 2012 were evaluated. We decide a cut-off of 70 years based on a literature review. Statistical analysis Statistical analysis based on CHAID (Chi-square Automatic Interaction Detector) and evaluation of odds ratio has been performed. Results Mean age was 77, 76% of patients were male and 24% female. Squamous cell carcinoma accounted for 80% of tumors. ASA score was 2 in 38% and 3 in 45% of patients. Only 20% of patients developed post-operative complications. Statistical analysis showed that the most significant predictor is the duration of surgical operation. More than 2 hours is the significant cut-off and after that complications rise from 20% to 54%. Another significant predictor of complications is the type of operations. Predictive factors of complications are evaluated and a practical algorithm is presented. Conclusion Oncologic surgery in elderly head and neck cancer patients is feasible and relatively safe. The presented algorithm may help surgeon to decide whether or not perform surgery in these patients since it is predictive for possible post-operative complications.