Open Partial Horizontal Laryngectomy in the Elderly: Oncological and Functional Outcomes

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Geriatric Oncology

Background:

• Open partial horizontal laryngectomy (OPHL) is a surgical option for laryngeal cancer.
• Elderly patients present unique challenges in oncological and functional recovery.
• Perioperative risk factors require careful consideration in this demographic.

Purpose of the Study:

• To investigate the oncological and functional prognostic implications of perioperative risk factors in elderly patients undergoing OPHL.
• To evaluate the safety and efficacy of OPHL in a geriatric population.
• To identify key factors influencing outcomes after OPHL in older adults.

Main Methods:

• Retrospective case-cohort study of 100 elderly patients with laryngeal squamous cell carcinoma (LSCC).
• Patients underwent open partial horizontal laryngectomy (OPHL) at a single institution.
• Univariate analysis was used to evaluate oncological and functional results.

Main Results:

• 19% overall recurrence rate; 2-year overall survival 72%, disease-specific survival 90%.
• 20% postoperative complications; 12% required percutaneous endoscopic gastrostomy for dysphagia.
• 80% successful decannulation; 26% experienced late sequelae, including 17 cases of postoperative laryngeal obstruction (POLO).

Conclusions:

• OPHL is a safe and effective therapeutic option for carefully selected elderly patients.
• Positive cervical nodes and positive surgical margins are significant negative prognostic factors for both oncological and functional outcomes.
• OPHL should be considered as a single-modality treatment in the elderly, with adjuvant therapy potentially impacting functional results.