Successful tongue cancer surgery under general anesthesia in a 99-year-old patient in Okinawa, Japan: A case report and review of the literature

Maruyama,Tessho; Nakasone,Toshiyuki; Matayoshi,Akira; Arasaki,Akira

doi:10.3892/ol.2016.4864

Successful tongue cancer surgery under general anesthesia in a 99-year-old patient in Okinawa, Japan: A case report and review of the literature

Authors:
- Tessho Maruyama
- Toshiyuki Nakasone
- Akira Matayoshi
- Akira Arasaki
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Affiliations: Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903‑0215, Japan, Department of Clinical Neuroscience, Oral and Maxillofacial Functional Rehabilitation, University of the Ryukyus Hospital, Nishihara, Okinawa 903‑0215, Japan
Published online on: July 15, 2016 https://doi.org/10.3892/ol.2016.4864
Pages: 1675-1678
Copyright: © Maruyama et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

As advances in the medical field have resulted in increased life expectancy, performing surgery under general anesthesia in elderly patients has become an important issue. A 99-year-old Okinawan female was admitted to the hospital presenting with pain in the tongue. Following physical examination, a clinical diagnosis of early stage tongue cancer (T2N0Mx) was confirmed. Early stage tongue cancer is particularly easy to access for surgical resection. By contrast, later stages of tongue cancer are associated with pain, dysphagia and throat obstruction. The patient and their family agreed to surgery due to the worsening pain associated with the tumor and gave informed consent for surgery. Following consultation with a cardiologist and an anesthesiologist, the tongue tumor was surgically resected under general anesthesia. Subsequent to surgery, the patient experienced pain relief and was discharged from the hospital on day 14 post‑surgery. The patient was able to maintain the same quality of life, and lived for 5 years and 2 months longer without evidence of disease, surviving to the age of 104 years old. The present case demonstrates that surgery under general anesthesia may be appropriate in patients of an advanced age, with a treatment plan that should ideally be based on careful assessment of the wishes of the patient and their family, medical risks, and benefits and economic costs of alternative treatments, in addition to consideration of the patient's culture.

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1	Rosenthal RA and Kavic SM: Assessment and management of the geriatric patient. Crit Care Med. 32(Suppl 4): S92–S105. 2004. View Article : Google Scholar : PubMed/NCBI
2	Imbelloni LE, Lima U and Pedrosa FK: Successful anesthesia and hip surgery in a 107-year-old patient. Am J Case Rep. 15:308–311. 2014. View Article : Google Scholar : PubMed/NCBI
3	Chien CR and Shih YC: Use of personalized decision analysis in decision making for palliative vs. surgical management of the oldest-old patients with localized skin cancer in a culturally sensitive environment: A case study of a 96-year-old male Taiwanese patient. J Pain Symptom Manage. 45:792–797. 2013. View Article : Google Scholar : PubMed/NCBI
4	Japan Statistics Bureau: Japan Population Statistics. http://www.stat.go.jp/data/jinsui/pdf/201407.pdfAccessed. July 22–2014(In Japanese).
5	Shah JP: Surgical approaches to the oral cavity primary and neck. Int J Radiat Oncol Biol Phys. 69(Suppl 2): S15–S18. 2007. View Article : Google Scholar : PubMed/NCBI
6	Sobin LH, Gospodarowicz MK and Wittekind C: Head and Neck tumours. TNM Classification of Malignant Tumours. O'Sullivan B: (7th). Wiley-Blackwell. (Oxford). 22–62. 2009.
7	Suzuki M, Willcox B and Willcox C: Successful aging: Secrets of okinawan longevity. Geriatr Gerontol Int. 4(s1): S180–S181. 2004. View Article : Google Scholar
8	Sho H: History and characteristics of Okinawan longevity food. Asia Pac J Clin Nutr. 10:159–164. 2001. View Article : Google Scholar : PubMed/NCBI
9	Iseki K: Screening and prevention of renal disease: Large population study in Okinawa, Japan. Nephrology. 4:S86–S89. 1998. View Article : Google Scholar
10	Clayman GL, Eicher SA, Sicard MW, Razmpa E and Goepfert H: Surgical outcomes in head and neck cancer patients 80 years of age and older. Head Neck. 20:216–223. 1998. View Article : Google Scholar : PubMed/NCBI
11	National Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Older Adult Oncology. 2015.http://www.nccn.org/professionals/physician_gls/pdf/senior.pdfAccessed. January 15–2015
12	Forster MC and Calthorpe D: Mortality following surgery for proximal femoral fractures in centenarians. Injury. 31:537–539. 2000. View Article : Google Scholar : PubMed/NCBI
13	Warner MA, Saletel RA, Schroeder DR, Warner DO, Offord KP and Gray DT: Outcomes of anesthesia and surgery in people 100 years of age and older. J Am Geriatr Soc. 46:988–993. 1998. View Article : Google Scholar : PubMed/NCBI
14	Katlic MR: Surgery in centenarians. JAMA. 253:3139–3141. 1985. View Article : Google Scholar : PubMed/NCBI
15	Ozorio G and Chan DK: Surgery in the very elderly. Intern Med J. 37:837–838. 2007. View Article : Google Scholar : PubMed/NCBI
16	Bridges CR, Edwards FH, Peterson ED, Coombs LP and Ferguson TB: Cardiac surgery in nonagenarians and centenarians. J Am Coll Surg. 197:347–357. 2003. View Article : Google Scholar : PubMed/NCBI
17	Peters TT, van Dijk BA, Roodenburg JL, van der Laan BF and Halmos GB: Relation between age, comorbidity and complications in patients undergoing major surgery for head and neck cancer. Ann Surg Oncol. 21:963–970. 2014. View Article : Google Scholar : PubMed/NCBI
18	Barzan L, Veronesi A, Caruso G, Serraino D, Magri D, Zagonel V, Tirelli U, Comoretto R and Monfardini S: Head and neck cancer and ageing: A retrospective study in 438 patients. J Laryngol Otol. 104:634–640. 1990. View Article : Google Scholar : PubMed/NCBI
19	VanderWalde NA, Fleming M, Weiss J and Chera BS: Treatment of older patients with head and neck cancer: A review. Oncologist. 18:568–578. 2013. View Article : Google Scholar : PubMed/NCBI
20	Takeda S, Noji H, Hirose N, Arai Y, Yamamura K, Shimizu K, Homma S, Ebihara Y and Takayama M: Nutritional intake by the oldest elderly Japanese. Tokyo Centenarian Study 6. Nippon Ronen Igakkai Zasshi. 35:548–558. 1998.(In Japanese). View Article : Google Scholar : PubMed/NCBI
21	Solomon DH: A statement of principles: Toward improved care of older patients in surgical and medical specialities. J Am Geriatr Soc. 48:699–701. 2000. View Article : Google Scholar : PubMed/NCBI
22	Siddiqui F and Gwede CK: Head and neck cancer in the elderly population. Semin Radiat Oncol. 22:321–333. 2012. View Article : Google Scholar : PubMed/NCBI
23	Syrigos KN, Karachalios D, Karapanagiotou EM, Nutting CM, Manolopoulos L and Harrington KJ: Head and neck cancer in the elderly: An overview on the treatment modalities. Cancer Treat Rev. 35:237–245. 2009. View Article : Google Scholar : PubMed/NCBI
24	Sarris EG, Harrington KJ, Saif MW and Syrigos KN: Multimodal treatment strategies for elderly patients with head and neck cancer. Cancer Treat Rev. 40:465–475. 2014. View Article : Google Scholar : PubMed/NCBI