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

Andy Bertolin1, Giovanni Succo2,3, Erika Crosetti2

  • 1Otolaryngology Unit, Vittorio Veneto Hospital (Treviso), Vittorio Veneto, Italy.

The Laryngoscope
|January 15, 2025
PubMed
Summary
This summary is machine-generated.

Open partial horizontal laryngectomy (OPHL) is a safe and effective option for elderly patients with laryngeal cancer. Careful patient selection is crucial, as positive nodes and margins negatively impact oncological and functional outcomes.

Keywords:
OPHLelderlyfunctionaloncologicalpartial laryngectomy

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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.