Predictors of postoperative complications and survival in patients with major salivary glands malignancies: A study highlighting the influence of age†
Corresponding Author
Thomas T. A. Peters MD
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, Groningen, The Netherlands
Corresponding author: T. T. A. Peters, Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands. E-mail: [email protected]Search for more papers by this authorBoukje A. C. van Dijk PhD
Department of Research, Comprehensive Cancer Centre the Netherlands, Utrecht, The Netherlands
Search for more papers by this authorJan L. N. Roodenburg MD, PhD
Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorBoudewijn E. C. Plaat MD, PhD
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorJan Wedman MD
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorBernard F. A. M. van der Laan MD, PhD
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, Groningen, The Netherlands
Search for more papers by this authorGyorgy B. Halmos MD, PhD
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorCorresponding Author
Thomas T. A. Peters MD
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, Groningen, The Netherlands
Corresponding author: T. T. A. Peters, Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands. E-mail: [email protected]Search for more papers by this authorBoukje A. C. van Dijk PhD
Department of Research, Comprehensive Cancer Centre the Netherlands, Utrecht, The Netherlands
Search for more papers by this authorJan L. N. Roodenburg MD, PhD
Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorBoudewijn E. C. Plaat MD, PhD
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorJan Wedman MD
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorBernard F. A. M. van der Laan MD, PhD
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), University of Groningen, Groningen, The Netherlands
Search for more papers by this authorGyorgy B. Halmos MD, PhD
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorThis work was partially presented at the 8th International Conference on Head and Neck Cancer in Toronto, Canada, July 21–25, 2012.
Abstract
Background
The purpose of this study was to reveal prognostic factors for surgical complications and survival in young and elderly patients with malignant salivary gland tumors.
Methods
Retrospective analysis of surgically treated patients with malignant major salivary gland tumors was performed. Of the 111 patients, 33 patients were 70 years or older and 78 patients were under 70. Comorbidity was recorded using the Adult Comorbidity Evaluation-27 index and complications using the Clavien–Dindo classification.
Results
Comorbidity and complications were significantly more frequent in elderly patients (p < .05). Age, comorbidity, and length of surgery were not significant independent predictors of complications. Stage was the only independent predictive factor for postoperative complications and disease-specific survival.
Conclusion
Based on this retrospective analysis reviewing surgically treated patients, age alone should not be a reason to treat elderly patients differently, as it was not a predictor of either complications or disease-specific survival. © 2013 Wiley Periodicals, Inc. Head Neck 36: 369–374, 2014
REFERENCES
- 1Van Dijk BA, Gatta G, Capocaccia R, et al.Rare cancers of the head and neck area in Europe.Eur J Cancer2012; 48: 783–796.
- 2Bj⊘rndal K, Krogdahl A, Therkildsen MH, et al.Salivary gland carcinoma in Denmark 1990–2005: outcome and prognostic factors. Results of the Danish Head and Neck Cancer Group (DAHANCA).Oral Oncol2012; 48: 179–185.
- 3Terhaard CH, Lubsen H, Rasch CR, et al.The role of radiotherapy in the treatment of malignant salivary gland tumors.Int J Radiat Oncol Biol Phys2005; 61: 103–111.
- 4Noh JM, Ahn YC, Nam H, et al.Treatment results of major salivary gland cancer by surgery with or without postoperative radiation therapy.Clin Exp Otorhinolaryngol2010; 3: 96–101.
- 5Guzzo M, Locati LD, Prott FJ, Gatta G, McGurk M, Licitra L.Major and minor salivary gland tumors.Crit Rev Oncol Hematol2010; 74: 134–148.
- 6Pinkston JA, Cole P.Incidence rates of salivary gland tumors: results from a population-based study.Otolaryngol Head Neck Surg1999; 120: 834–840.
- 7Peters TT, van der Laan BF, Plaat BE, Wedman J, Langendijk JA, Halmos GB.The impact of comorbidity on treatment-related side effects in older patients with laryngeal cancer.Oral Oncol2011; 47: 56–61.
- 8Peters TT, Langendijk JA, Plaat BE, et al.Co-morbidity and treatment outcomes of elderly pharyngeal cancer patients: a matched control study.Oral Oncol2011; 47: 1159–1164.
- 9Terhaard CH, van der Schroeff MP, van Schie K, et al.The prognostic role of comorbidity in salivary gland carcinoma.Cancer2008; 113: 1572–1579.
- 10Hocwald E, Korkmaz H, Yoo GH, et al.Prognostic factors in major salivary gland cancer.Laryngoscope2001; 111: 1434–1439.
- 11Kowalski LP, Alcantara PS, Magrin J, Parise Júnior O.A case-control study on complications and survival in elderly patients undergoing major head and neck surgery.Am J Surg1994; 168: 485–490.
- 12Borggreven PA, Kuik DJ, Quak JJ, de Bree R, Snow GB, Leemans CR.Comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and oropharynx with microvascular soft tissue reconstruction.Head Neck2003; 25: 808–815.
- 13Clayman GL, Eicher SA, Sicard MW, Razmpa E, Goepfert H.Surgical outcomes in head and neck cancer patients 80 years of age and older.Head Neck1998; 20: 216–223.
10.1002/(SICI)1097-0347(199805)20:3<216::AID-HED6>3.0.CO;2-3 CAS PubMed Web of Science® Google Scholar
- 14Suh JD, Sercarz JA, Abemayor E, et al.Analysis of outcome and complications in 400 cases of microvascular head and neck reconstruction.Arch Otolaryngol Head Neck Surg2004; 130: 962–966.
- 15Derks W, de Leeuw JR, Hordijk GJ, Winnubst JA.Reasons for non-standard treatment in elderly patients with advanced head and neck cancer.Eur Arch Otorhinolaryngol2005; 262: 21–26.
- 16Cheung MC, Franzmann E, Sola JE, Pincus DJ, Koniaris LG.A comprehensive analysis of parotid and salivary gland cancer: worse outcomes for male gender.J Surg Res2011; 171: 151–158.
- 17Bell RB, Dierks EJ, Homer L, Potter BE.Management and outcome of patients with malignant salivary gland tumors.J Oral Maxillofac Surg2005; 63: 917–928.
- 18Terhaard CH, Lubsen H, Van der Tweel I, et al.Salivary gland carcinoma: independent prognostic factors for locoregional control, distant metastases, and overall survival: results of the Dutch head and neck oncology cooperative group.Head Neck2004; 26: 681–692; discussion 692–693.
- 19Oplatek A, Ozer E, Agrawal A, Bapna S, Schuller DE.Patterns of recurrence and survival of head and neck adenoid cystic carcinoma after definitive resection.Laryngoscope2010; 120: 65–70.
- 20Kim JY, Lee S, Cho KJ, et al.Treatment results of post-operative radiotherapy in patients with salivary duct carcinoma of the major salivary glands.Br J Radiol2012; 85: e947–e952.
- 21Piccirillo JF, Tierney RM, Costas I, Grove L, Spitznagel EL Jr.Prognostic importance of comorbidity in a hospital-based cancer registry.JAMA2004; 291: 2441–2447.
- 22Clavien PA, Barkun J, de Oliveira ML, et al.The Clavien–Dindo classification of surgical complications: five-year experience.Ann Surg2009; 250: 187–196.
- 23Dindo D, Demartines N, Clavien PA.Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey.Ann Surg2004; 240: 205–213.
- 24Ferrier MB, Spuesens EB, Le Cessie S, Baatenburg de Jong RJ.Comorbidity as a major risk factor for mortality and complications in head and neck surgery.Arch Otolaryngol Head Neck Surg2005; 131: 27–32.
- 25Sanabria A, Carvalho AL, Melo RL, et al.Predictive factors for complications in elderly patients who underwent head and neck oncologic surgery.Head Neck2008; 30: 170–177.
- 26Piccirillo JF, Spitznagel EL Jr, Vermani N, Costas I, Schnitzler M.Comparison of comorbidity indices for patients with head and neck cancer.Med Care2004; 42: 482–486.
- 27Paleri V, Wight RG, Silver CE, et al.Comorbidity in head and neck cancer: a critical appraisal and recommendations for practice.Oral Oncol2010; 46: 712–719.
- 28Beausang ES, Ang EE, Lipa JE, et al.Microvascular free tissue transfer in elderly patients: the Toronto experience.Head Neck2003; 25: 549–553.
- 29Blackwell KE, Azizzadeh B, Ayala C, Rawnsley JD.Octogenarian free flap reconstruction: complications and cost of therapy.Otolaryngol Head Neck Surg2002; 126: 301–306.
- 30Perisanidis C, Herberger B, Papadogeorgakis N, et al.Complications after free flap surgery: do we need a standardized classification of surgical complications?Br J Oral Maxillofac Surg2012; 50: 113–118.
- 31Ciuman RR, Oels W, Jaussi R, Dost P.Outcome, general, and symptom-specific quality of life after various types of parotid resection.Laryngoscope2012; 122: 1254–1261.
- 32Maddox PT, Paydarfar JA, Davies L.Parotidectomy: a 17-year institutional experience at a rural academic medical center.Ann Otol Rhinol Laryngol2012; 121: 100–103.
- 33de Cássia Braga Ribeiro K, Kowalski LP, Latorre Mdo R.Perioperative complications, comorbidities, and survival in oral or oropharyngeal cancer.Arch Otolaryngol Head Neck Surg2003; 129: 219–228.
- 34Al-Mamgani A, van Rooij P, Sewnaik A, Tans L, Hardillo JA.Adenoid cystic carcinoma of parotid gland treated with surgery and radiotherapy: long-term outcomes, QoL assessment and review of the literature.Oral Oncol2012; 48: 278–283.
Citing Literature
