Long-term quality of life and psycho-social outcomes after oropharyngeal cancer surgery and radial forearm free-flap reconstruction: A GETTEC prospective multicentric study.
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; Reconstructive Surgical Procedures/methods; Surgical Flaps; Surveys and Questionnaires; Survival Rate; Anxiety; Depression; Head and neck cancer; Oropharynx cancer; Psychosocial outcomes; Surgery
Abstract :
[en] 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.
Disciplines :
Otolaryngology
Author, co-author :
Bozec, Alexandre
Demez, Pierre
Gal, Jocelyn
Chamorey, Emmanuel
Louis, Marie-Yolande
Blanchard, David
De Raucourt, Dominique
Merol, Jean-Claude
Brenet, Esteban
Dassonville, Olivier
Poissonnet, Gilles
Santini, Jose
Peyrade, Frederic
Benezery, Karen
Lesnik, Maria
Berta, Etienne
RANSY, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service d'ORL, d'audiophonologie et de chir. cervico-faciale
Long-term quality of life and psycho-social outcomes after oropharyngeal cancer surgery and radial forearm free-flap reconstruction: A GETTEC prospective multicentric study.
Publication date :
2018
Journal title :
Surgical Oncology
ISSN :
0960-7404
Publisher :
Elsevier, Netherlands
Volume :
27
Issue :
1
Pages :
23-30
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2017 Elsevier Ltd. All rights reserved.
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