Sesterhenn Andreas M, Schotte Tobias L, Bauhofer Artur, Timmesfeld Nina, Wiegand Susanne, Werner Jochen A, Ovassapian Andranik, Torossian Alexander
Department of Otolaryngology-Head and Neck Surgery, University of Marburg, Germany.
Ann Otol Rhinol Laryngol. 2011 Feb;120(2):110-5. doi: 10.1177/000348941112000207.
There is international consensus that elderly patients with head and neck cancer should be treated curatively, like younger patients. Because of common comorbidities in elderly patients, perioperative complications are likely. The McPeek postoperative outcome score was used to evaluate the success of surgical interventions in patients with head and neck cancer.
We included 168 patients in the study (56 in the study group, 75 years of age or more; and 112 in the control group, less than 60 years of age). All patients underwent major surgery for head and neck cancer.
The median McPeek scores were 8 in the study group and 9 in the control group (p = 0.04). Regression analysis revealed that neither age (p = 0.085) nor the American Society of Anesthesiologists physical status score (p = 0.342) were independent predictors of the McPeek score. Synchronous surgical interventions (p = 0.00051) and duration of surgery (p = 0.0015) had a significant impact on McPeek score performance.
The McPeek score seems to be an appropriate tool for comparing major surgeries for head and neck cancer in different age groups. It is possible to assess the influence of anesthetic and surgical interventions and complications that affect the length of hospitalization. The results confirm that the overall complication rate after surgery in elderly patients does not differ significantly from that in their younger counterparts. Therefore, extended surgical treatment should be offered to both age groups when no serious comorbidities are present. The postoperative outcome seems to depend on the duration and extent of the surgical intervention.
国际上达成的共识是，老年头颈癌患者应像年轻患者一样接受根治性治疗。由于老年患者常见合并症，围手术期并发症很可能发生。McPeek术后结果评分用于评估头颈癌患者手术干预的成功率。
我们纳入了168例患者进行研究（研究组56例，年龄75岁及以上；对照组112例，年龄小于60岁）。所有患者均接受了头颈癌大手术。
研究组McPeek评分中位数为8分，对照组为9分（p = 0.04）。回归分析显示，年龄（p = 0.085）和美国麻醉医师协会身体状况评分（p = 0.342）均不是McPeek评分的独立预测因素。同步手术干预（p = 0.00051）和手术时长（p = 0.0015）对McPeek评分表现有显著影响。
McPeek评分似乎是比较不同年龄组头颈癌大手术的合适工具。可以评估麻醉和手术干预以及影响住院时间的并发症的影响。结果证实，老年患者术后总体并发症发生率与年轻患者相比无显著差异。因此，在不存在严重合并症的情况下，两个年龄组均应提供扩大的手术治疗。术后结果似乎取决于手术干预的持续时间和范围。
