期刊
JOURNAL OF SURGICAL ONCOLOGY
卷 108, 期 3, 页码 187-191出版社
WILEY
DOI: 10.1002/jso.23370
关键词
head and neck cancer; geriatric oncology; preoperative care
资金
- Memorial Sloan-Kettering Cancer Center
Background and Objectives Perioperative management of elderly patients with head and neck cancer poses unique challenges. Our objective is to describe the implementation and feasibility of a novel intervention designed to improve perioperative care in geriatric head and neck surgery. Methods This pilot study was performed in a single-institution, NCI-designated comprehensive cancer center. All surgical patients with head and neck cancer over age 75 were offered perioperative consultation with fellowship-trained geriatricians focusing in geriatric oncology. Results Between 2010 and 2011, a total of 168 patients requiring head and neck surgery were seen by the geriatric service, of which 94% subsequently underwent surgery. Apart from preoperative medical optimization, geriatricians assisted in complex decision-making regarding the indications for cancer-directed therapy. Postoperatively, they assisted in preventing and treating delirium and poly-pharmacy, facilitating discharge planning, and initiating rehabilitation. Postoperatively, 87% were discharged home, and 13% required placement in skilled nursing facilities. At 24 months, overall survival was 80%. Patients, surgeons and geriatricians alike were enthusiastic about the initiative, which is expanding within the institution. Conclusion Geriatric perioperative support for elderly head and neck cancer patients is well-received with promising potential. (c) 2013 Wiley Periodicals, Inc.
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