Abstract
ObjectivesOlder head and neck cancer patients are at increased risk for adverse health outcomes, but little is known about which geriatric assessment associates with poor outcome. The aim is to study the association of functional or cognitive impairment, social environment and frailty with adverse health outcomes in patients with head and neck cancer. MethodsFour libraries were searched for studies reporting on an association of functional or cognitive impairment, social environment and frailty with adverse outcomes in head and neck cancer patients. ResultsOf 4158 identified citations, 31 articles were included. The mean age was ⩾60years in twelve studies (39%). Geriatric conditions were prevalent: between 40 and 50% of the included participants were functional impaired, around 50% had depressive symptoms, and around 40% did not have a partner. Functional impairment was assessed in 18 studies, two studies reported on a cognitive test, eight studies examined mood and social status was depicted by 14 studies. None of the included studies addressed frailty or objectively measured physical capacity such as hand grip strength, gait speed or balance tests. In 64% of the reported associations, a decline in functional or cognitive impairment, mood or social environment was associated with adverse outcomes. ConclusionFunctional and cognitive impairment, depressive symptoms and social isolation are highly prevalent in head and neck cancer patients and associate with high risk of adverse health outcomes. In the future, these measurements may guide decision-making and customize treatments, but more research is needed to further improve and firmly establish clinical usability.
Highlights
With population ageing there will be an increasing number of older patients with cancer
Older patients are very heterogenic with respect to functional capacity, cognitive functioning, mobility and frailty, it remains challenging to identify older patients who are at highest risk for adverse health outcomes such as delirium, side-effects, prolonged length of hospital stay, reduced quality of life or mortality
Cross referencing yielded one additional relevant article, which resulted in a total of 31 studies that were included in the present review
Summary
With population ageing there will be an increasing number of older patients with cancer. This trend can be observed in the patient population presenting with head and neck cancer. ⇑ Corresponding author at: Department of Gerontology and Geriatrics, Leiden. 1 L.A. van der Velden and S.P. Mooijaart should be considered joint last authors of this work. Head and neck cancer patients have a severe prognosis with an estimation of 50% after 5 years with large variations across tumor sites [2,3]. The prognostic value of functional capacity, cognitive functioning, mobility and frailty to assist clinical decision making in older head and neck cancer patients has not been systematically evaluated
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