Surgical Treatment of Elderly Patients with Laryngeal / Hypopharyngeal Cancer

Abstract

Japan is facing a super-aging society. As of October 2022, 29% of the population was ≥65 years of age, and 15.5% was ≥75 years of age, and this trend is expected to continue. With this demographic shift, opportunities to treat elderly patients (age : ≥75 years) with head and neck cancer have increased. Cancer registry data have revealed an increase in the number of elderly laryngeal and hypopharyngeal cancers, and there is a need to establish safe and effective treatments for these elderly patients.

When considering the surgical treatment of elderly patients with head and neck cancer, many factors, such as tissue fragility, decreased organ reserve, altered pharmacokinetics, and the possibility of postoperative cognitive dysfunction, can make treatment difficult. Despite these difficulties, we have performed surgical treatment for elderly patients with laryngeal or hypopharyngeal cancer as long as their performance status is maintained and the procedure is considered tolerable.

From 2008 to 2022, we performed open surgery and transoral surgery for laryngeal/hypopharyngeal cancer in 18 and 49 elderly patients, respectively. No surgery-related deaths occurred, and 66 patients were eventually able to achieve oral intake. The satisfactory survival rates suggest that physicians should not hesitate to perform surgical treatment for elderly patients when the situation permits.