caa a22 4500 606185267 CHVBK 20210128100831.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00405-014-3268-z doi (NATIONALLICENCE)springer-10.1007/s00405-014-3268-z Free flap reconstruction for head and neck cancer can be safely performed in both young and elderly patients after careful patient selection [Elektronische Daten] [Thomas Peters, Sophie Post, Boukje van Dijk, Jan Roodenburg, Bernard van der Laan, Paul Werker, Gyorgy Halmos] Surgical treatment of head and neck cancer often results in complex defects requiring reconstruction with microvascular free tissue transfer. However, in elderly patients, curative treatment with radical surgery and free flap reconstruction is often withheld. The objective of this study is to assess the outcomes of free flap surgery in elderly patients, using a standard surgical complication classification system. A retrospective review was conducted of patients who underwent primary free flap reconstruction following major surgery for head and neck cancer between 1995 and 2010. Complications were assessed using the Clavien Dindo classification system, and grades III-V were classified as major complications. Comorbidity was classified according to the adult comorbidity evaluation index 27. A comparison was done between patients <70 and ≥70years. Two hundred-two patients were included in this study. Multivariate analysis showed that only disease stage was a significant predictor of recipient site complications, and comorbidity was the only significant predictor of medical complications. Age was not a predictor of complications. There were no significant differences in disease specific or overall survival between young and elderly patients. Optimal patient selection for free flap surgery is essential. This requires thorough pre-operative assessment, including analysis of comorbidity in both young and elderly patients. Patients' biological age, and not chronological age, should be individually determined to assess feasibility of major surgery. Patients should not be denied surgery based on age alone. Springer-Verlag Berlin Heidelberg, 2014 Head and neck cancer nationallicence Free flap reconstruction nationallicence Elderly nationallicence Complications nationallicence Peters Thomas Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands aut Post Sophie Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aut van Dijk Boukje Department of Research, Comprehensive Cancer Center The Netherlands, Utrecht, The Netherlands aut Roodenburg Jan Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aut van der Laan Bernard Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands aut Werker Paul Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aut Halmos Gyorgy Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/10(2015-10-01), 2999-3005 0937-4477 272:10<2999 2015 272 405 https://doi.org/10.1007/s00405-014-3268-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3268-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Peters Thomas Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Post Sophie Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aut NATIONALLICENCE 700 1- van Dijk Boukje Department of Research, Comprehensive Cancer Center The Netherlands, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Roodenburg Jan Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aut NATIONALLICENCE 700 1- van der Laan Bernard Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Werker Paul Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Halmos Gyorgy Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/10(2015-10-01), 2999-3005 0937-4477 272:10<2999 2015 272 405