Health-Related Quality of Life in Oral Cancer Patients: Scoping Review and Critical Appraisal of Investigated Determinants

Abstract

Background: health-related quality of life (HRQOL) represents a secondary endpoint of medical interventions in oncological patients. Our aim was to highlight potential sources of bias that could be encountered when evaluating HRQOL in oral cancer patients. Methods: this review followed PRISMA-ScR recommendations. Participants: patients treated for oral cancer. Concept: HRQOL assessed by EORTC QLQ-C30 and QLQ-H&N35/QLQ-H&N43. A critical appraisal of included studies was performed to evaluate the accuracy of data stratification with respect to HRQOL determinants. Results: overall, 30 studies met the inclusion criteria, totaling 1833 patients. In total, 8 sociodemographic (SDG) and 15 disease/treatment-specific (DT) HRQOL determinants (independent variables) were identified. The mean number of the independent variables was 6.1 (SD, 4.3)—5.0 (SD, 4.0) DT-related and 1.1 (SD, 1.8) SDG-related variables per article. None of the included papers considered all the identified determinants simultaneously. Conclusions: a substantial lack of evidence regarding HRQOL determinants was demonstrated. This strongly weakens the reliability of the reported findings due to the challenging presence of baseline confounding, selection, and omitted variable biases. The proposed approach recommends the use of further evaluation tools that gather more variables in a single score together with a selection of more homogeneous, reproducible, and comparable cohorts based on the identified baseline confounding.

MicroRNA-21 Expression as a Prognostic Biomarker in Oral Cancer: Systematic Review and Meta-Analysis

“…More than 350,000 new cases of OSCC are diagnosed every year worldwide, but the poor prognosis of oral cancer has not improved significantly in recent decades [ 2 ], with a tendency to worsen even for the young population [ 3 ]. The 5-year survival rate of patients with oral cancer is less than 50% [ 4 ], and the therapies applied, including surgery, radiotherapy, and chemotherapy, lead to a significant reduction in the quality of life [ 5 , 6 ].…”

Resective Surgery versus Debridement in Stage 2 Medication-Related Osteonecrosis of the Jaw

“…In our study we quantified QoL with EORTC and calculated the considerable increase obtained in patients subject to surgical resection (group A) compared to slight improvements in patients subject to surgical debridement (group B). Despite the fact that underlying oncological condition of the patients has an impact on their overall quality of life, the same starting condition in the preoperative phase (62.68% vs. 62.37%) let us analyze the differences that appeared during the concomitant MRONJ treatment [66]. Since lower scores corresponds to better perceived quality of life by the patients, the difference between the two groups is evident.…”

Questionnaire-Based Assessment of the Masticatory Function and Facial Nerve Recovery Post Pterional Approach in Brain Tumors Surgery

“…Patient-centered outcomes assessment questionnaires are objective and widely accepted measurement tools for the assessment of health care quality and are essential for providing patient-centered care [ 19 , 20 , 21 , 22 ]; they are strongly recommended by the European Medicines Agency and the U.S. Food and Drug Administration as relevant endpoints for approving new therapeutical strategies [ 7 ].…”

“…Patient-reported outcomes acquires directly patient’s feedback regarding their feeling or function in relation to a certain health conditions and are considered by the European Medicines Agency (EMA) and the U.S. Food and Drug Administration (FDA), relevant endpoints for approving new therapies [ 7 ]. Thus, well-addressed self-reporting outcomes could improve surgical techniques and postoperative care.…”