Long-term quality of life after surgery of head and neck cancer with microvascular reconstruction: a prospective study with 4.9-years follow-up

Abstract

Purpose The aim of this study was to evaluate the long-term health-related quality of life (HRQoL) of head and neck cancer patients with microvascular surgery. Surgical treatment causes great changes in patient HRQoL. Studies focusing on long-term HRQoL after microvascular reconstruction for head and neck cancer patients are scarce. Methods We conducted a prospective study of 93 patients with head and neck cancer and microvascular reconstruction in Helsinki University Hospital Finland. HRQoL was measured using the 15D instrument at baseline and after a mean 4.9-years follow up. Results were compared with those of an age-standardized general population. Results Of the 93 patients, 61 (66%) were alive after follow-up; of these, 42 (69%) answered the follow-up questionnaire. The median time between surgery and HRQoL assessment was 4.9 years (range 3.7–7.8 years). The mean 15D score of all patients (n = 42) at the 4.9-years follow up was statistically significantly (p = 0.010) and clinically importantly lower than at baseline. The dimensions of “speech” and “usual activities” were significantly impaired at the end of follow up. There was a significant difference at the 4.9-years follow-up in the mean 15D score between patients and the general population (p = 0.014). After follow up, patients were significantly (p < 0.05) worse off on the dimensions of “speech,” “eating,” and “usual activities.” Conclusions Long-term HRQoL was significantly reduced in the whole patient cohort. Speech and usual activities were the most affected dimensions in head and neck cancer patients with microvascular reconstruction at the end of the 4.9-years follow up.

Quality of life in head and neck cancer patients at 5 years after free flap reconstruction: a significant decline during the follow-up

“…There is a limited number of previous studies focusing on long-term QoL in head and neck cancer survivors operated with free flap reconstruction. The present results are in line with the results reported by relatively recent Finnish study with a narrower range of assessments [ 7 ]. The probable reason for limited number of studies is the high mortality in this patient group but also the small cohorts limiting the possibilities for long-term follow-up.…”

“…According to our knowledge, most of the previous studies have reported the evaluations only up to 2 years after the operation and the number of studies focusing on the QoL in a longer follow-up is limited. In one Finnish survey, the QoL was assessed with 15D-tool and the study showed a reduction in the QoL during a 5-year follow-up [ 7 ].…”

Higher incidences of neuropathic pain and altered sensation following radial forearm free flap: A systematic review

“…Sensory morbidities vary largely between 0% and 46% 9 and incidences of neuropathic pain in the donor-site have, to our knowledge, not been reported in the literature. As RFFF surgery is often performed as a part of oncological head and neck reconstructions, follow-up focuses on the survival of the disease or severely disabling complications in the recipient site, including speech and mastication impairment 10 , rather than on pain in the donorsite. Therefore, neuropathic pain in the donor -site is likely to be missed or underdiagnosed.…”

Quality of Life Assessment for Tonsillar Infections and Their Treatment

“…It was published in 1981 according to the WHO definition of health and revised in 1986 and 1992. Because of the vast accumulated experience with its use during the last few decades, it has been used to assess various health conditions for common otolaryngologic diseases [ 11 , 12 , 13 , 14 ]. This allows for good comparability in this area of research.…”