[Head and neck cancer in the elderly-current aspects]

Area of Science:

• Otorhinolaryngology
• Geriatric Oncology
• Surgical Oncology

Background:

• Head and neck cancer treatment relies heavily on surgery and radiochemotherapy, often causing high morbidity.
• Elderly patients present unique challenges, questioning the rationality of aggressive treatments due to limited data and guidelines.
• The increasing proportion of geriatric patients with head and neck tumors necessitates tailored clinical approaches.

Purpose of the Study:

• To establish concrete clinical recommendations for geriatric patients with head and neck tumors.
• To base recommendations on a systematic literature search.
• To aid decision-making regarding invasive treatment for elderly head and neck cancer patients.

Main Methods:

• A systematic literature search using keywords was conducted.
• The current evidence level for geriatric head and neck cancer treatment was assessed.
• A clinical algorithm for risk stratification was developed.

Main Results:

• Pretreatment evaluation for geriatric patients must include age, psychosocial status, functional capacity, and medical comorbidities.
• An algorithm was created for individual pretreatment risk stratification based on comprehensive patient data.
• This approach facilitates personalized decisions for or against invasive treatment.

Conclusions:

• Pretreatment risk stratification is crucial for deciding on invasive treatment for geriatric head and neck cancer patients.
• Current evidence is limited, highlighting the need for further research.
• A clinical algorithm is provided to assist otorhinolaryngologists and head and neck surgeons.