Health-related quality of life: a retrospective study on local vs. microvascular reconstruction in patients with oral cancer

Abstract

Background New medicinal and surgical oncological treatment strategies not only improve overall survival rates but continually increase the importance of Health-Related Quality of Life (HRQOL). The purpose of this retrospective cross-sectional study was to analyze HRQOL of patients with oral squamous cell carcinoma after ablative surgery and to evaluate predictive factors for HRQOL outcome. Methods The study included 88 patients with histologically confirmed oral squamous cell carcinoma of whom 42 had undergone local reconstruction (LR) and 46 microvascular reconstruction (MVR). During follow-up, all patients completed the University of Washington Quality of Life Questionnaire (UW-QOL) containing 12 targeted questions about the head and neck. Descriptive analyses were made for the tumor site, the T-stage, and adjuvant therapies. HRQOL was compared between the LR and the MVR group with parametric tests. Further analyses were impact of the tumor site, the T-status, and the time from surgery to survey on HRQOL. Statistics also included multivariate correlations and different interaction effects. Results HRQOL in the LR group was ‘very good’ with 84.3 ± 13.7 and ‘good’ in the MVR group with 73.3 ± 16.5 points. The physical domains swallowing ( p = 0.00), chewing ( p = 0.00), speech ( p = 0.01), taste ( p = 0.01), and pain ( p = 0.04) were significantly worse in the MVR group. An increase in the T-status had a significant negative effect on swallowing ( p = 0.01), chewing ( p = 0.01), speech ( p = 0.03), recreation ( p = 0.05), and shoulder ( p = 0.01) in both groups. Regarding the tumor site and subsequent loss of HRQOL, patients with squamous cell carcinoma on the floor of the mouth had significantly worse results in the categories pain ( p = 0.002), speech ( p = 0.002), swallowing ( p = 0.03), activity ( p = 0.02), and recreation ( p = 0.01) than patients with tumors in the buccal mucosa. Speech ( p = 0.03) and pain ( p = 0.01) had improved 1 year after surgery. Conclusion Patients with flap reconstruction because of oral squamous cell carcinoma showed very good overall HRQOL. Outcomes for microvascular reconstruction were good, even in the case of larger defects. The T-status is a predictor for HRQOL. Swallowing, chewing, speaking, taste, and pain were the most important issues in our cohort. Implementing HRQOL questionnaires for the assessment of quality of life could further increase the treatment quality of patients with oral cancer.

Treatment delay and tumor size in patients with oral cancer during the first year of the COVID‐19 pandemic

“…What is undisputed, however, is an increased morbidity and mortality associated with larger tumors, which require a comprehensive treatment regimen that includes both more extensive surgical and adjuvant procedures. Although the prognosis for patients with oral cancer has improved in recent decades, 16 the COVID‐19‐related increases in tumor size have a significant impact on prognosis 17 and quality of life 18,19 …”

“…Although the prognosis for patients with oral cancer has improved in recent decades, 16 the COVID‐19‐related increases in tumor size have a significant impact on prognosis 17 and quality of life. 18 , 19 …”

<p>Short-Term Quality of Life, Functional Status, and Their Predictors in Tongue Cancer Patients After Anterolateral Thigh Free Flap Reconstruction: A Single-Center, Prospective, Comparative Study</p>

“…Fujimoto et al 30 reported similar findings regarding age; however, their study had a follow-up period of six months. Meier et al 31 reported similar findings regarding the tumor site, while Hahn et al reported similar findings regarding denture use. We identified illness duration (p = 0.005), drinking habit (p = 0.023), and diet (p = 0.035) as factors predicting the patients' quality of life at three months after the surgery.…”

Technique for secondary modification after maxillary resection and reconstruction for soft tissue flap fixation before prosthesis addition: a case report

“…Maxillectomy can result in severe functional problems resulting from impaired mastication and deglutition [1–4]. Maxillary defects following flap reconstruction are repaired using obturator prostheses, dentures, or implants [12–14].…”

“…Treatment of massive malignant tumors of the maxilla can open communication between the oral, nasal, and orbital cavities, thereby resulting in hypernasal speech, food, and liquid countercurrent in the nasal cavity, dysphagia, masticatory disturbance, and facial disfigurement [1–4]. Free flap reconstruction can be used to repair various tissue defects resulting from removal of a maxillary carcinoma [5].…”