高龄对部分喉切除术后生活质量和功能恢复轨迹的影响
Impact of advanced age on quality of life and functional recovery trajectories following partial laryngectomy.
文献信息
| PMID | 42760363 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sang Hoo Park |
| 作者单位 | Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 年龄对部分喉切除术（PL）后长期生活质量（QoL）恢复的影响仍不明确。本研究比较了因喉癌接受PL的老年与年轻患者之间的纵向QoL轨迹。
方法： 52例接受PL的患者被分为老年组（≥ 65岁，n = 25）或年轻组（< 65岁，n = 27）。使用欧洲癌症研究与治疗组织生活质量问卷核心30（EORTC QLQ-C30）和头颈部模块（QLQ-H&N35）在术前以及术后1、3、12和24个月评估QoL。采用Mann-Whitney U检验分析各时间点的组间差异。进一步使用广义估计方程（GEE）评估纵向恢复模式，纳入年龄组、时间、年龄组与时间的交互作用，并以糖尿病作为协变量。
结果： 两组均显示术后早期总体QoL下降，随后逐渐恢复。在调整后的纵向分析中，QLQ-C30总结评分未显示显著的总体年龄组效应或年龄组与时间的交互作用。然而，在随访期间，老年患者言语恢复较慢且体重下降更为明显，而吞咽方面的组间差异在调整糖尿病后不再显著。至24个月时，两组的总体健康相关QoL大致相当。
结论： 仅高龄本身不应排除对经过适当选择的患者考虑部分喉切除术。尽管长期总体QoL恢复在年龄组间无显著差异，但老年患者在术后第一年内部分功能结局方面表现出恢复延迟，尤其是言语和营养状况。这些发现支持对接受PL的老年患者进行密切术后监测和积极康复。
英文摘要
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.