van Deudekom Floor J, van der Velden Lilly-Ann, Zijl Willianne H, Schimberg Anouk S, Langeveld Anton P, Slingerland Marije, Blauw Gerard J, Mooijaart Simon P
Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Head Neck. 2019 Aug;41(8):2477-2483. doi: 10.1002/hed.25714. Epub 2019 Feb 28.
The aim is to describe the association of functional capacity and cognitive functioning with 1-year mortality in older patients with cancer in the head and neck region.
We performed a cohort study in which all patients aged 70 years and older received a geriatric screening before treatment. Main outcome was 1-year mortality.
A total of 102 patients were included. Median age was 78.7 years (interquartile range [IQR], 72.3-84.5), 25% were cognitive impaired, 40% were malnourished, and 28.4% used a walking device. Overall, 1-year mortality was 42.3%. Male sex (hazard ratio [HR], 4.30; 95% confidence interval [CI], 1.35-13.67), malnutrition (HR, 2.55; 95% CI, 1.19-5.16), and using a walking device (HR, 2.80; 95% CI 1.13-6.93) were associated with higher mortality risk, independent of stage and comorbidities.
In older patients with head and neck cancer, the mortality rates are high. Nutritional status and mobility are determinants of 1-year mortality, independent of tumor stage, age, and comorbidity.
目的是描述头颈部癌症老年患者的功能能力和认知功能与1年死亡率之间的关联。
我们进行了一项队列研究，所有70岁及以上的患者在治疗前接受了老年病筛查。主要结局是1年死亡率。
共纳入102例患者。中位年龄为78.7岁（四分位间距[IQR]，72.3 - 84.5），25%存在认知障碍，40%营养不良，28.4%使用助行器。总体而言，1年死亡率为42.3%。男性（风险比[HR]，4.30；95%置信区间[CI]，1.35 - 13.67）、营养不良（HR，2.55；95% CI，1.19 - 5.16）和使用助行器（HR，2.80；95% CI 1.13 - 6.93）与较高的死亡风险相关，与分期和合并症无关。
在老年头颈部癌症患者中，死亡率较高。营养状况和活动能力是1年死亡率的决定因素，与肿瘤分期、年龄和合并症无关。
