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Outcomes of comprehensive geriatric assessment and surgical management in head and neck cancers of the elderly: an observational study

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Abstract

Aim

The aims of this study were to assess the survival benefit of optimal vs suboptimal management in elderly patients presenting with upper aerodigestive tract (UADT) cancer for which surgery was the standard of care, and determine if comprehensive geriatric assessment (CGA) was a prognostic factor for survival.

Materials and methods

This single-center retrospective cohort study was conducted from January 2014 to December 2018. Included patients were aged 70 or older at the time of diagnosis, and presented with UADT cancer with a theoretical indication for curative-intent surgery according to international guidelines.

Results

A total of 188 patients were included, with a median age of 78 years. Treatment included surgery in 67.6% of cases and was considered optimal in 60.6% of patients. The overall 3-year survival was 55.2%, and was significantly better in case of optimal vs suboptimal treatment (74.5% vs 25.8%, p < 0.001). In univariate analysis, factors associated with a significantly improved 3-year survival included surgery (p < 0.001), age < 80 years, performance status < 2 and G8 score > 14. In multivariate analysis, CGA was associated with a better survival.

Conclusions

In patients aged over 70 presenting with UADT cancer for which the standard of care is surgery, an optimal management is associated with better overall survival. Receiving a CGA seems to provide a survival benefit in patients with a G8 score ≤ 14, through an optimization of the care pathway before and after the cancer treatment.

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Availability of data and materials

The corresponding author declares to be able to disclose all the data regarding this study.

Code availability

Not applicable.

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Acknowledgements

The authors thank Anne-Laure Fize for her logistical support during the study declaration, and Christophe Lagadic for the data management.

Funding

None.

Author information

Authors and Affiliations

  1. Department of Surgery, University Cancer Institute of Toulouse, Oncopole, 1 avenue Irène Joliot-Curie, 31100, Toulouse, France

    Thanaphone Banh Chong, Emilien Chabrillac, Sébastien Vergez & Agnès Dupret-Bories

  2. Tarn Cancer Registry, Claudius Regaud Institute, University Cancer Institute of Toulouse, Oncopole, Toulouse, France

    Pascale Grosclaude

  3. CERPOP, UMR 1295 Inserm Toulouse III University, Toulouse, France

    Pascale Grosclaude

  4. Department of Gerontology, Toulouse University Hospital, La Grave Hospital, Place Lange, 31059, Toulouse, France

    Stéphanie Lozano

  5. Department of Medical Oncology, Claudius Regaud Institute, University Cancer Institute of Toulouse, Oncopole, Toulouse, France

    Loïc Mourey

Authors
  1. Thanaphone Banh Chong
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  2. Pascale Grosclaude
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  7. Agnès Dupret-Bories
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Contributions

AD-B, PG and TBC contributed to the study conception and design. Material preparation and data collection were performed AD-B and TBC. Data analysis was performed by PG. Data interpretation was performed by AD-B, EC, SV, LM, SL. The first draft of the manuscript was written by TBC, EC and AD-B. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Emilien Chabrillac.

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Banh Chong, T., Grosclaude, P., Chabrillac, E. et al. Outcomes of comprehensive geriatric assessment and surgical management in head and neck cancers of the elderly: an observational study. Eur Arch Otorhinolaryngol 280, 329–338 (2023). https://doi.org/10.1007/s00405-022-07559-5

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