Sang Hoo Park, Younghac Kim, Eun-Hye Kim, Taek Yoon Cheong, Man Ki Chung, Han-Sin Jeong, Young-Ik Son, Nayeon Choi
Advanced age alone should not preclude consideration of partial laryngectomy in appropriately selected patients. Although long-term overall QoL recovery did not differ significantly between age groups, elderly patients showed delayed recovery in selected functional outcomes, particularly speech and nutritional status, during the first postoperative year. These findings support close postoperative surveillance and proactive rehabilitation in elderly patients undergoing PL.
BACKGROUND: The influence of age on long-term quality of life (QoL) recovery after partial laryngectomy (PL) remains unclear. This study compared longitudinal QoL trajectories between elderly and younger patients undergoing PL for laryngeal cancer.
METHODS: 52 patients who underwent PL were categorized as elderly (≥ 65 years, n = 25) or younger (< 65 years, n = 27). QoL was assessed preoperatively and at 1, 3, 12, and 24 months postoperatively using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Head and Neck Module (QLQ-H&N35). Between-group differences at each time point were analyzed using the Mann-Whitney U test. Longitudinal recovery patterns were further evaluated using generalized estimating equations (GEE) including age group, time, the age group-by-time interaction, and diabetes mellitus as a covariate.
RESULTS: Both groups showed an early postoperative decline in overall QoL followed by gradual recovery. In the adjusted longitudinal analysis, the QLQ-C30 summary score showed no significant overall age-group effect or age group-by-time interaction. However, recovery of speech was slower and weight loss remained more pronounced in elderly patients during follow-up, whereas the between-group difference in swallowing was no longer significant after adjustment for diabetes mellitus. By 24 months, overall health-related QoL was broadly comparable between groups.
CONCLUSIONS: Advanced age alone should not preclude consideration of partial laryngectomy in appropriately selected patients. Although long-term overall QoL recovery did not differ significantly between age groups, elderly patients showed delayed recovery in selected functional outcomes, particularly speech and nutritional status, during the first postoperative year. These findings support close postoperative surveillance and proactive rehabilitation in elderly patients undergoing PL.