Integrated geriatric assessment and intervention in the head and neck oncology care pathway reduces adverse events and does not affect survival

作者：Beniamino Vincenzoni Padovan, Marleen Beenker, Johannes A. Langendijk, Hans Paul van der Laan, Boukje A. C. van Dijk, Geertruida H. de Bock, Boudewijn E. C. Plaat, Pauline de Graeff, Suzanne Festen, György B. Halmos · 发表于：Oral Oncology · 年份：2025 · DOI：10.1016/j.oraloncology.2025.107811 · 被引用次数：1 · 研究领域：Frailty in Older Adults、Nutrition and Health in Aging、Dysphagia Assessment and Management

OBJECTIVE: The number of older/frail patients with head and neck cancer (HNC) is increasing. They are more frail compared to patients with other malignancies. Therefore, geriatric care is increasingly integrated into the HNC care pathway. The aim of this study was to investigate how integrated geriatric care affects treatment outcomes in HNC patients irrespective of treatment intention. METHODS: This retrospective study compared treatment-related adverse outcomes (grade ≥ 2 Clavien-Dindo surgical complications and grade ≥ 2 CTCAE (chemo)radiotoxicity), and one-year mortality in two patient cohorts. In the first cohort (2014-2016), geriatric screening was only observational i.e. without intervention. In the second cohort (2019-2020), a complete geriatric pathway was integrated into the oncological care pathway, including an onco-geriatric MDT (multidisciplinary team meeting), referral to the geriatrician with intervention, if needed. Multivariable logistic regression analysis was performed to identify factors associated with adverse events and one-year mortality, including the cohort period. RESULTS: This study included 640 patients; 369 from the first cohort and 271 from the second cohort. The second cohort showed significantly fewer adverse events (34.6 %) compared to the first (65.4 %) (OR 0.41; 95 % CI 0.27-0.63: p < 0.001). Reductions were seen in surgical complications (OR 0.57; 95 % CI 0.32-1.01) as well as (chemo)radiotoxicity (OR 0.39; 95 % CI 0.20-0.76). No significa...