Anna Luíza Damaceno Araújo, Luiz Paulo Kowalski, Alvaro Sanabria, Alan Roger Santos-Silva, Andrés Coca-Pelaz, Kevin Thomas Robbins, Juan P Rodrigo, Orlando Guntinas-Lichius, Fernando López, Antti A Mäkitie, Remco de Bree, Timo Strandberg, Alessandra Rinaldo, Cesare Piazza, Robert P Takes, Nabil F Saba, Alfio Ferlito
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The significance of age as a prognostic factor and how it should influence treatment decisions is debated, highlighting the need for tailored insights to help physicians make more informed choices.</p><p><strong>Objective: </strong>This scoping review aims to address the diagnostic challenges/differences and patient outcomes as infection, pain, treatment-related complications (either postmedical or postoperative), treatment toxicities, disease control, morbidity, and/or survival/mortality in older patients (above the cut-off age of 60 years) with head and neck cancer.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, Web of Science, and LILACS were searched, as well as gray literature and reference lists of included articles.</p><p><strong>Results: </strong>A total of 5029 articles were retrieved and 57 studies were included, among which 5 appraised evidence on diagnostic challenges/differences, 53 addressed clinical (as postoperative complications, the impact of comorbidities in the occurrence of complications and treatment, postoperative delirium, swallowing outcomes, the correlation between age and infections, pain and opioid use, morbidity rates, treatment-related toxicities), and 26 reported survival. Evidence on diagnostic challenges and outcomes between older and younger patients is mixed, but age, comorbidities, and complications must be considered. While many studies show no significant differences in complications according to age, comorbidities often correlate with worse outcomes and are more frequent in the older group. Despite variable age cut-offs, survival rates between older and younger patients are similar.</p><p><strong>Conclusion: </strong>Treatment decisions should be based on a thorough medical evaluation and patient preferences rather than chronological age alone, as age itself does not account for outcome differences.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Older Patients with Head and Neck Cancer: A Scoping Review of Differences Regarding Diagnosis and Outcomes.\",\"authors\":\"Anna Luíza Damaceno Araújo, Luiz Paulo Kowalski, Alvaro Sanabria, Alan Roger Santos-Silva, Andrés Coca-Pelaz, Kevin Thomas Robbins, Juan P Rodrigo, Orlando Guntinas-Lichius, Fernando López, Antti A Mäkitie, Remco de Bree, Timo Strandberg, Alessandra Rinaldo, Cesare Piazza, Robert P Takes, Nabil F Saba, Alfio Ferlito\",\"doi\":\"10.1002/hed.28168\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Understanding the relationship between age and diagnostic challenges, as well as outcomes in older patients with head and neck cancer, is crucial. 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引用次数: 0
摘要
背景：了解年龄与诊断挑战之间的关系以及老年头颈癌患者的预后是至关重要的。年龄作为预后因素的重要性以及它应该如何影响治疗决策是有争议的，这突出了需要量身定制的见解来帮助医生做出更明智的选择。目的：本综述旨在探讨老年头颈癌患者（60岁以上）的诊断挑战/差异和患者结局，如感染、疼痛、治疗相关并发症（医疗后或术后）、治疗毒性、疾病控制、发病率和/或生存/死亡率。方法：检索PubMed、Embase、Scopus、Web of Science和LILACS，并检索纳入文章的灰色文献和参考文献。结果：共检索到5029篇文献，纳入57项研究，其中5项评价了诊断挑战/差异的证据，53项涉及临床（如术后并发症、合并症对并发症发生和治疗的影响、术后谵妄、吞咽结果、年龄与感染、疼痛和阿片类药物使用、发病率、治疗相关毒性的相关性），26项报告了生存率。关于老年和年轻患者之间的诊断挑战和结果的证据是混合的，但必须考虑年龄、合并症和并发症。虽然许多研究显示不同年龄的并发症没有显著差异，但合并症往往与较差的结果相关，而且在老年人中更为常见。尽管年龄界限不同，但老年和年轻患者的存活率是相似的。结论：治疗决定应基于彻底的医学评估和患者的偏好，而不是仅仅根据实际年龄，因为年龄本身并不能解释结果的差异。
Older Patients with Head and Neck Cancer: A Scoping Review of Differences Regarding Diagnosis and Outcomes.
Background: Understanding the relationship between age and diagnostic challenges, as well as outcomes in older patients with head and neck cancer, is crucial. The significance of age as a prognostic factor and how it should influence treatment decisions is debated, highlighting the need for tailored insights to help physicians make more informed choices.
Objective: This scoping review aims to address the diagnostic challenges/differences and patient outcomes as infection, pain, treatment-related complications (either postmedical or postoperative), treatment toxicities, disease control, morbidity, and/or survival/mortality in older patients (above the cut-off age of 60 years) with head and neck cancer.
Methods: PubMed, Embase, Scopus, Web of Science, and LILACS were searched, as well as gray literature and reference lists of included articles.
Results: A total of 5029 articles were retrieved and 57 studies were included, among which 5 appraised evidence on diagnostic challenges/differences, 53 addressed clinical (as postoperative complications, the impact of comorbidities in the occurrence of complications and treatment, postoperative delirium, swallowing outcomes, the correlation between age and infections, pain and opioid use, morbidity rates, treatment-related toxicities), and 26 reported survival. Evidence on diagnostic challenges and outcomes between older and younger patients is mixed, but age, comorbidities, and complications must be considered. While many studies show no significant differences in complications according to age, comorbidities often correlate with worse outcomes and are more frequent in the older group. Despite variable age cut-offs, survival rates between older and younger patients are similar.
Conclusion: Treatment decisions should be based on a thorough medical evaluation and patient preferences rather than chronological age alone, as age itself does not account for outcome differences.
期刊介绍：
Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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