The number of elderly laryngeal cancer patients is increasing in Japan. However, there are no established guidelines supported by sufficient evidence for the management of elderly cancer patients. Chronological age sometimes differs from biological or functional age in elderly cancer patients. In addition, these patients have different comorbidities, physical functions, cognitive functions, family and financial backgrounds, and values. Therefore, it is often necessary to accurately assess the overall health status and concerns of elderly patients with cancer using geriatric assessment (GA) and its screening tools when making treatment decisions. In particular, for elderly patients with locally advanced laryngeal cancer, cisplatin-based chemoradiotherapy, which is the standard nonsurgical treatment for laryngeal preservation, is often difficult to choose in clinical practice because of its toxicity and the possibility of decline in the laryngeal function, especially the swallowing function, during or after treatment. However, laryngectomy is often indicated when GA is proposed appropriately. There may also be cases in which minimally invasive transoral surgery is acceptable. A multidisciplinary team approach by several professionals before, during, and after treatment plays an important role in maintaining the quality of life and improving treatment efficacy.
