Long-term quality of life and psycho-social outcomes after oropharyngeal cancer surgery and radial forearm free-flap reconstruction: A GETTEC prospective multicentric study.

Abstract

OBJECTIVE:

To assess long-term quality of life (QoL) and psycho-social outcomes, and to determine their predictive factors after oropharyngeal cancer (OPC) surgery and radial forearm free-flap (RFFF) reconstruction.

METHODS:

Patients who had undergone OPC surgery and RFFF reconstruction who were still alive and disease-free at least 1 year after surgery were enrolled in this prospective multicentric study. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core (QLQ-C30) and Head and Neck Cancer (QLQ-H&N35) QoL questionnaires, the Voice Handicap Index (VHI-10) questionnaire and the Hospital Anxiety and Depression Scale (HADS). The level of dysphagia was evaluated using the Dysphagia Handicap Index (DHI) and the Dysphagia Outcomes and Severity Scale (DOSS). Predictive factors of these clinical outcomes were determined in univariate and multivariate analysis.

RESULTS:

A total of 58 patients were included in this study. Long-term QoL and functioning scales scores were well-preserved (all superior to 70%). Main persistent symptoms were fatigue, reduced sexuality and oral function-related disorders (swallowing, teeth, salivary and mouth-opening problems). HADS anxiety and depression scores were 7.2 and 5.4, respectively. Twenty-one (36%) patients presented an anxiodepressive disorder (HADS global score ≥ 15). Among the 21 patients who were still working before surgery, 11 (52%) had returned to work at the time of our study. The HADS global score (p < 0.001) was the main predictor of QoL, VHI-10 and DOSS scores.

CONCLUSIONS:

Psychological distress is the main determinant of long-term QoL and is therefore of critical importance in the multidisciplinary management of OPC patients.

• Authors: Alexandre Bozec, Pierre Demez, Jocelyn Gal, Emmanuel Chamorey, Marie-Yolande Louis, David Blanchard, Dominique De Raucourt, Jean-Claude Merol, Esteban Brenet, Olivier Dassonville, Gilles Poissonnet, José Santini, Frédéric Peyrade, Karen Benezery, Maria Lesnik, Etienne Berta, Pierre Ransy, Emmanuel Babin
• Journal: Surgical oncology (Surg Oncol) Vol. 27 Issue 1 Pg. 23-30 (Mar 2018) ISSN: 1879-3320 [Electronic] Netherlands
• PMID: 29549900 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2017 Elsevier Ltd. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Squamous Cell (pathology, psychology, surgery)
• Female
• Follow-Up Studies
• Forearm (surgery)
• Humans
• Male
• Middle Aged
• Oropharyngeal Neoplasms (pathology, psychology, surgery)
• Prognosis
• Prospective Studies
• Quality of Life
• Plastic Surgery Procedures (methods)
• Surgical Flaps
• Surveys and Questionnaires
• Survival Rate