Role of Frailty and Comorbidity in Determination of Operability for Patients With Oral and Oropharyngeal Squamous Cell Carcinoma

  • Erik T. Interval
  • Nicholas Whitenack
  • Aru PanwarEmail author
HEAD & NECK: Oral Cavity and Oropharyngeal Cancer (W Lydiatt, Section Editor)
Part of the following topical collections:
  1. Topical Collection on HEAD & NECK: Oral Cavity and Oropharyngeal Cancer
  2. Topical Collection on HEAD & NECK: Oral Cavity and Oropharyngeal Cancer


Purpose of Review

To review the role of frailty and comorbidities in determining operability and associated outcomes in patients with oral and oropharyngeal squamous cell carcinoma.

Recent Findings

Frailty and comorbidity have been linked to multiple adverse outcome measures including risk of mortality, surgical complications, length of stay, intensity of care needs, discharge disposition, risk of readmission, and cost of healthcare delivery. There are diverse objective and validated measures of comorbidity and frailty. Addition of comorbidity and objective frailty measurements has been demonstrated to improve predictive power of nomograms and clinical staging systems for patients with oral and oropharyngeal squamous cell carcinoma. The use of predictive tools that assess frailty may contribute to shared decision making, realistic expectations, and facilitation of appropriate level of care. While emerging literature supports the role of prehabilitation, there is paucity of data in support of such interventions for patients afflicted by oral and oropharyngeal cancer.


Frailty assesses operability beyond anatomic resectability and incorporates key determinants of physical, nutritional, and cognitive well-being. Objective measurements of frailty predict meaningful outcomes following surgery for cancers of the oral cavity and oropharynx. This paper suggests that clinicians should objectively and routinely assess frailty, which may facilitate patient counseling, improved risk stratification, informed decision making, and further research to elucidate relationship of frailty with outcomes in head and neck specific populations.


Frailty Outcomes Comorbidity Head and neck cancer Oral cancer Oropharyngeal cancer 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Erik T. Interval
    • 1
  • Nicholas Whitenack
    • 2
  • Aru Panwar
    • 1
    Email author
  1. 1.Head and Neck Surgical Oncology, Methodist Estabrook Cancer CenterNebraska Methodist HospitalOmahaUSA
  2. 2.Department of SurgeryCreighton University Medical CenterOmahaUSA

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