Chirurgie von Karzinomen der oberen Luft- und Speisewege bei Patienten im fortgeschrittenen Lebensalter

Teymoortash, Afshin; Wulf, H.; Werner, JA

doi:10.1055/s-2002-25319

Cited by 16 publications

(9 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As has been previously suggested [3,19,20] , chronological age alone should not be a contraindication to aggressive surgical approach, which should be attempted whenever risk-assessment ration is favorable. In a large retrospective series of 810 patients > 65 years who had undergone major head and neck resections, Morgan et al [21] reported an acceptable overall mortality rate of 3.5%.…”

Section: Surgerymentioning

confidence: 86%

“…Feasibility: Surgery should be offered as the preferred treatment when the primary tumor can be removed with clear margins without causing major functional compromise; Such an aggressive approach with a curative intent can also be considered for the elderly HNC patients [19] . The choice of radical local therapy must be based on a number of aspects, including the potential functional outcome of treatment, the comprehensive geriatric assessment, the life expectancy and, importantly, the patient's wishes.…”

Section: Surgerymentioning

confidence: 99%

“…Surgery was reported to be less often used for older patients: 13.9% vs 27.4% for the primary site and 15.4% vs 35.6% for neck lesions [18] . Combined modalities including surgery and irradiation or chemoradiotherapy were also less frequently administered in the elderly patient population than in the younger patients: 22.3% vs 9.7% and 14.1% vs 0.2%, respectively [19] . Systemic chemotherapy as exclusive treatment was less frequently used for elderly: 5.5% vs 17.6% and, even in these cases, it was mainly used as palliative treatment.…”

Section: General Principlesmentioning

confidence: 99%

See 2 more Smart Citations

Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy

Mountzios¹

2015

WJCO

View full text Add to dashboard Cite

Head and neck cancer (HNC) represents the sixth most common malignancy and accounts for approximately 6% of new cancer cases annually worldwide. As life expectancy constantly increases, the onset of HNC in patients older than 65 years of age at diagnosis is not rare and up to one fourth of cases occurs in patients older that 70 years at age. Because elderly cancer patients are severely under-represented in clinical trials, there is a clear need to address the particular aspects of this specific patient group, especially in the context of novel multidisciplinary therapeutic approaches. The frailty of elderly patients with HNC is attributed to the high incidence of smoking and alcohol abuse in this malignancy and the presence of substantial cardiovascular, respiratory or metabolic comorbidities. In the current work, I provide an overview of current and emerging treatment approaches, in elderly patients with HNC. In particular, I discuss modern surgical approaches that improve radical excision rates while preserving functionality, the incorporation of modern radiotherapeutic techniques and the introduction of novel chemotherapeutic combinations and molecular targeted agents in an effort to reduce toxicity without compromising efficacy. Finally, there is an urgent need to increase accrual and active participation of elderly patients with HNC in clinical trials, including biomarker evaluation in biopsy specimens towards an individualized therapeutic approach.

show abstract

Section: Surgerymentioning

confidence: 86%

Section: Surgerymentioning

confidence: 99%

Section: General Principlesmentioning

confidence: 99%

See 1 more Smart Citation

Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy

Mountzios¹

2015

WJCO

View full text Add to dashboard Cite

show abstract

“…Surgery can be effective in elderly HNM patients if the primary tumor could be excised without causing severe postoperative dysfunction [14]. Airoldi et al [15] reported the treatment outcome of performing surgery with postoperative CRT for elderly HNM patients (median age, 73.5 years [range, 70–78 years]).…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of retrograde intra-arterial chemotherapy concurrent with radiotherapy for elderly oral squamous cell carcinoma patients aged over 80 years old

et al. 2017

View full text Add to dashboard Cite

BackgroundThe aim of this retrospective observational study was to evaluate toxicities, overall survival, and locoregional control in elderly oral squamous cell carcinoma patients who had undergone retrograde intra-arterial chemotherapy combined with radiotherapy.MethodsThirty-one elderly patients over 80 years old with oral squamous cell carcinoma were enrolled in present study. The treatment schedule consisted of intra- arterial chemotherapy (docetaxel, total 60 mg/m2; cisplatin, total 150 mg/m2) and daily concurrent radiotherapy (total, 60 Gy) for 6 weeks.ResultsThe median patient age was 82.5 years old (range, 80–88 years). Of the 31 patients, six (19%) had stage II, 6 (19%) had stage III, 17 (55%) had stage IVA, and 2 (6%) had stage IVB. The median follow-up period for all patients was 37 months (range, 7–86 months). The 3-year overall survival and locoregional control rates were 78% and 81%, respectively. The major acute grade 3 adverse events were oral mucositis in 22 (71%) patients, neutropenia in 16 (52%), and dermatitis in 11 (35%). With respect to late toxicities, 1 patient (3%) developed grade 3 osteoradionecrosis of the jaw. No grade 4 or higher toxicities were observed during the treatment and follow-up periods.ConclusionsRetrograde intra-arterial chemotherapy combined with radiotherapy was effective in improving overall survival and locoregional control even for elderly patients.

show abstract

“…Hals Chronologisches Alter hat keinen Einfluss auf die Therapieentscheidung bei Kopf-Hals-Tumoren. erhöhen, empfehlen einige Autoren die enge Kooperation und intensive Kommunikation mit den Kollegen der Anästhesie[9]. Eine kurze Rekonvaleszenzphase sowie eine rasche postoperative Mobilisation von Patienten mit PEC der oberen Luft-und Speisewege reduziert das Risiko thrombembolischer Komplikationen.…”

unclassified

Therapie von Kopf-Hals-Karzinomen im fortgeschrittenen Lebensalter

Sesterhenn

2007

Laryngo-Rhino-Otol

View full text Add to dashboard Cite

In the years to come health care systems of western industrialized nations are going to be increasingly faced with the results of demographic changes. Especially the part of elderly citizens will grow steadily. Thus, also an increasing number of malignant diseases not only in the head & neck area is expected. Decision-making in cancer therapy for elderly patients is challenging for medical professional since this subject is accompanied by a high rate of uncertainness. For fear of aggressive therapy regimens with subsequent increase of morbidity, in many cases only incomplete diagnostic and therapeutic measures are taken. Reviewing the literature there is almost complete international consensus, that patients suffering from squamous cell cancer of the head & neck should be treated with curative intention, if thorough preoperative assessment of present comorbidities is performed. Furthermore aggressive treatment options should not be excluded. An optimal medical adjustment of relevant concomitant diseases clearly improves the starting point. In comparison to younger control groups therapy associated complications do not occur significantly higher. For this reason elderly patients should be treated with curative intention. Age itself should never be a sole factor deciding which curative therapy should be undertaken. Exceptions could be made in patients with severe general comorbidity.

show abstract

Chirurgie von Karzinomen der oberen Luft- und Speisewege bei Patienten im fortgeschrittenen Lebensalter

Abstract: Head and neck cancer patients of all age groups should have a treatment of equal quality regardless of whether the expected outcome is cure or palliation.

Cited by 16 publications

References 9 publications

Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy

Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy

Clinical outcomes of retrograde intra-arterial chemotherapy concurrent with radiotherapy for elderly oral squamous cell carcinoma patients aged over 80 years old

Therapie von Kopf-Hals-Karzinomen im fortgeschrittenen Lebensalter

Contact Info

Product

Resources

About