Microsurgical Reconstructions for XXXX in Elderly Aged >80  Years: An Analysis of Surgical Outcomes and Quality of Life.

@entity1 @entity135 @entity5
BACKGROUND: The rising incidence of primary @entity135 in the elderly presents a dilemma regarding the appropriateness of complex surgery in this assumed frail age group. With limited data on surgical morbidity, survival, and @entity1 quality of life (QOL), this analysis aimed to broaden the understanding of safety and effectiveness of microsurgical treatment in very elderly H_N @entity5 @entity1 . METHODS: A prospective database analysis was used to evaluate surgical outcomes (morbidity, survival, and QOL) in all @entity1 aged 80  years and older undergoing microsurgical reconstruction for cutaneous and @entity5 between 2004 and 2014. Outcomes were assessed for their association with surgical, @entity5 , and @entity1 variables. Comorbidities were categorized by the ACE27 index and postoperative morbidity by the Clavien-Dindo scoring system. QOL was analyzed using the UW-QOLv4. RESULTS: Of 720 microsurgical reconstructions, 96 @entity1 were identified. Median survival was 25  months. The ACE27 index was the only variable significantly associated with survival with a 5-year survival of 59.2  % in the least comorbid group versus 19.7  % in the most comorbid group (p 0.015). ACE-27 showed influence on socioemotional QoL scores. Physical QOL scores were influenced by @entity5 and operative factors. @entity1 were found to value physical QOL over socioemotional. CONCLUSIONS: Microsurgical reconstructions are well tolerated in the very elderly @entity1 and should be considered predominantly based on comorbidity. @entity5 stage, flap type, and @entity5 site should still form part of the preoperative counseling due to their implication on postoperative physical function.
