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Koric A, Chang CP, Hu S, Snyder J, Deshmukh VG, Newman MG, Date AP, Monroe MM, Hashibe M. Oral health-related quality of life among oropharyngeal cancer survivors. Oral Oncol 2024; 159:107062. [PMID: 39362027 DOI: 10.1016/j.oraloncology.2024.107062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 09/27/2024] [Indexed: 10/05/2024]
Abstract
OBJECTIVES The incidence of oropharyngeal cancer continues to rise in the United States, yet studies on the quality of life (QoL) of oropharyngeal cancer patients are limited. The objective of this pilot study was to assess the impact of oral health on the QoL in oropharyngeal cancer survivors. MATERIALS AND METHODS Oropharyngeal cancer survivors with a confirmed cancer diagnosis from 1996 to 2016 were sampled from the Utah Cancer Registry. The Oral Health Impact Profile-14 (OHIP-14) questionnaire was administrated between January and May of 2019. The impact of oral health on QoL was evaluated using simple linear regression (β-coefficient). RESULTS Among the 260 oropharyngeal cancer survivors, the majority were male (84.6 %) and ≥ 60 years of age at the time of cancer diagnosis (74.0 %). The most frequently reported symptoms of OHIP-14 were discomfort while eating any foods (19.2 %) and worsening sense of taste (16.0 %). The overall OHIP-14 mean score was 13.3. Significantly worse OHIP-14 scores were observed for females (β = 12.85, p = 0.01), chemotherapy recipients (β = 6.60, p = 0.02), and past smokers (β = 5.25, p = 0.04). Better OHIP-14 scores (better oral QoL) were observed in patients with distant cancer stage (β = -7.66, p = 0.01), higher income (β = -2.50, p = 0.05), and older age at cancer diagnosis (β = -0.35, p = 0.03). CONCLUSION The oral health-related quality of life scores observed in this pilot study suggest a need for improvement in patient symptom management over time.
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Affiliation(s)
- Alzina Koric
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, United States; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, Utah, United States
| | - Chun-Pin Chang
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, Utah, United States
| | - Siqi Hu
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, Utah, United States
| | - John Snyder
- Intermountain Healthcare, Salt Lake City, Utah, United States
| | - Vikrant G Deshmukh
- University of Utah Health Sciences Center, Salt Lake City, Utah, United States
| | - Michael G Newman
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, Utah, United States; University of Utah Health Sciences Center, Salt Lake City, Utah, United States
| | - Ankita P Date
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, United States
| | - Marcus M Monroe
- Departments of Otolaryngology-Head and Neck Surgery, Salt Lake City, Utah, United States
| | - Mia Hashibe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, United States; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, Utah, United States.
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Gasparro R, Giordano F, Campana MD, Aliberti A, Landolfo E, Dolce P, Sammartino G, di Lauro AE. The Effect of Conservative vs. Radical Treatment of Ameloblastoma on Recurrence Rate and Quality of Life: An Umbrella Review. J Clin Med 2024; 13:5339. [PMID: 39274556 PMCID: PMC11396145 DOI: 10.3390/jcm13175339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 09/03/2024] [Accepted: 09/08/2024] [Indexed: 09/16/2024] Open
Abstract
Ameloblastoma is a rare, benign, but locally aggressive odontogenic tumor that originates from the epithelial cells involved in tooth development. The surgical approach to treating an ameloblastoma depends on the type, size, location, and extent of the tumor, as well as the patient's age and overall health. This umbrella review's aim is to summarize the findings from systematic reviews (SRs) and meta-analyses on the effect of radical or conservative treatment of ameloblastoma on the recurrence rate and quality of life, to evaluate the methodological quality of the included SRs and discuss the clinical management. Three electronic databases (PubMed, Scopus, The Cochrane Library) were checked. The primary outcome was the recurrence rate after surgical treatment, while the secondary outcomes were the post-operative complications, quality of life, esthetic, and functional impairment. The methodological quality of the included SRs was assessed using the updated version of "A Measurement Tool to Assess Systematic Review" (AMSTAR-2). Eighteen SRs were included. The quality of the included reviews ranged from critically low (three studies) to high (eight studies). Four studies were included in meta-analysis, and they revealed that the recurrence rate is about three-times more likely in the conservative treatment group compared to the radical treatment group, and this result is statistically significant. Despite the high recurrence rate, the latter was more appropriate in the case of smaller lesions and younger patients, due to better post-operative quality of life and reduced functional and esthetic impairments. Based on the results of this overview, conservative treatment may be recommended as the first-line approach for intraosseous ameloblastoma not involving soft tissue. However, given the expectation of a higher recurrence rate, it is advisable to reduce the interval between follow-up visits. However, further prospective studies are needed to establish the best treatment choice and follow-up period.
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Affiliation(s)
- Roberta Gasparro
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Oral Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Maria Domenica Campana
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Oral Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Angelo Aliberti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Oral Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Elena Landolfo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Oral Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Pasquale Dolce
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Gilberto Sammartino
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Oral Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Alessandro E di Lauro
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Oral Surgery, University of Naples Federico II, 80131 Naples, Italy
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Peters F, Raith S, Bock A, Kniha K, Ooms M, Möhlhenrich SC, Hölzle F, Modabber A. Accuracy of the surgical execution of virtually planned deep circumflex iliac artery flaps and their appropriateness for masticatory rehabilitation. Head Face Med 2024; 20:42. [PMID: 39135061 PMCID: PMC11321092 DOI: 10.1186/s13005-024-00444-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 08/06/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Tumorous diseases of the jaw demand effective treatments, often involving continuity resection of the jaw. Reconstruction via microvascular bone flaps, like deep circumflex iliac artery flaps (DCIA), is standard. Computer aided planning (CAD) enhances accuracy in reconstruction using patient-specific CT images to create three-dimensional (3D) models. Data on the accuracy of CAD-planned DCIA flaps is scarce. Moreover, the data on accuracy should be combined with data on the exact positioning of the implants for well-fitting dental prosthetics. This study focuses on CAD-planned DCIA flaps accuracy and proper positioning for prosthetic rehabilitation. METHODS Patients post-mandible resection with CAD-planned DCIA flap reconstruction were evaluated. Postoperative radiograph-derived 3D models were aligned with 3D models from the CAD plans for osteotomy position, angle, and flap volume comparison. To evaluate the DCIA flap's suitability for prosthetic dental rehabilitation, a plane was created in the support zone and crestal in the middle of the DCIA flap. The lower jaw was rotated to close the mouth and the distance between the two planes was measured. RESULTS 20 patients (12 males, 8 females) were included. Mean defect size was 73.28 ± 4.87 mm; 11 L defects, 9 LC defects. Planned vs. actual DCIA transplant volume difference was 3.814 ± 3.856 cm³ (p = 0.2223). The deviation from the planned angle was significantly larger at the dorsal osteotomy than at the ventral (p = 0.035). Linear differences between the planned DCIA transplant and the actual DCIA transplant were 1.294 ± 1.197 mm for the ventral osteotomy and 2.680 ± 3.449 mm for the dorsal (p = 0.1078). The difference between the dental axis and the middle of the DCIA transplant ranged from 0.2 mm to 14.8 mm. The mean lateral difference was 2.695 ± 3.667 mm in the region of the first premolar. CONCLUSION The CAD-planned DCIA flap is a solution for reconstructing the mandible. CAD planning results in an accurate reconstruction enabling dental implant placement and dental prosthetics.
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Affiliation(s)
- Florian Peters
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Stefan Raith
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Anna Bock
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Kristian Kniha
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Mark Ooms
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Stephan Christian Möhlhenrich
- Department of Orthodontics, University Witten/Herdecke, Private Universität Witten/Herdecke GmbH, Alfred-Herrhausen-Straße 45, 58448, Witten, Germany
| | - Frank Hölzle
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
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Grillo R, Balel Y, Brozoski MA, Stanbouly D, Samieirad S, de Oliveira NK. Science mapping analysis of maxillofacial reconstruction over the last four decades. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101701. [PMID: 37979780 DOI: 10.1016/j.jormas.2023.101701] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/02/2023] [Accepted: 11/15/2023] [Indexed: 11/20/2023]
Abstract
PURPOSE This paper aims to provide a bibliometric analysis of the maxillofacial reconstruction literature over 40 years and to compare the data with previous studies. METHODS A bibliographical search for oral and maxillofacial surgery literature in maxillofacial reconstruction was conducted on Wef of Science. A graphic representation of authorship and keywords was created with VOSviewer. Mendeley and Microsoft Excel were used for tabulation and data visualization. Some statistical tests were performed with a 95 % confidence interval, which was considered significant. RESULTS A total of 7417 articles from specialized journals were included in the study. These articles received 138,493 citations from 63,390 other studies, with an average citation count of 18.67, and a very high H-index. A total of 2375 specific keywords were analyzed, covering a wide range of topics, with two noteworthy MeSH keywords that have recently gained prominence. A total of 33 journals were included in the study, with a mean Impact Factor of 2.404, indicating a relatively high influence in the subject area. CONCLUSION The high h-index reflects abundant and high-quality literature on maxillofacial reconstruction, with the United States leading in publication quantity. Emerging topics in maxillofacial reconstruction were discussed. These areas shape the discipline, driving advancements and offering opportunities for researchers and clinicians to contribute to progress and improve patient outcomes.
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Affiliation(s)
- Ricardo Grillo
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis, Faculty of Dentistry of the University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP 05508-000, Brazil; Department of Oral and Maxillofacial Surgery, Faculdade Patos de Minas, Brasília, Brazil.
| | - Yunus Balel
- Department of Oral and Maxillofacial Surgery, University of Tokat Gaziosmanpasa, Tokat, Turkey; TR Ministry of Health, Oral and Dental Health Hospital, Sivas, Turkey
| | - Mariana Aparecida Brozoski
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis, Faculty of Dentistry of the University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP 05508-000, Brazil
| | - Dani Stanbouly
- College of Dental Medicine, Columbia University, New York, NY, USA
| | - Sahand Samieirad
- Department of Oral and Maxillofacial Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Natacha Kalline de Oliveira
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis, Faculty of Dentistry of the University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP 05508-000, Brazil
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Panaseykin YA, Kapinus VN, Filonenko EV, Polkin VV, Sevrukov FE, Smirnova MA, Isaev PA, Ivanov SA, Kaprin AD. Photodynamic therapy in treatment of squamous cell carcinoma of oral cavity with chlorine e6 photosensitizer with long-term follow up. BIOMEDICAL PHOTONICS 2024; 13:28-38. [DOI: 10.24931/2413-9432-2023-13-1-28-38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2024] Open
Abstract
Photodynamic therapy is an effective method for treating superficial forms of malignant neoplasms, characterized by a minimal risk of damage to normal tissues. In this study, we presented our experience of treating cancer of the oral mucosa using photodynamic therapy, and analyzed the immediate and long-term results of treatment. 38 patients with squamous cell carcinoma of oral cavity mucosa, with a depth of invasion no more than 7 mm, were included in the study. All patients underwent photodynamic therapy with chlorine e6 based photosensitizer. Photosensitizers were administered intravenously 3 hours before irradiation, at a dosage of 1 mg/kg of the patient’s weight. Photodynamic therapy was performed with the following parameters: P – 1.0 W, Ps – 0.31 W/cm2, E – 300 J/cm2. The area of one irradiation field ranged 1.0-2.0 cm2. Treatment effect was evaluated by RECIST 1.1. Overall survival, cancer-specific survival, and disease-free survival were calculated using Kaplan-Meier curves. Evaluation of adverse events was made by .TCAE 5.0 criteria. At 35 (92.1%) out of 38 cases, complete regression was observed after photodynamic therapy. Among them in 3 out of 35 patients relapse was diagnosed in 11.5 to 43.2 months. The total number of patients who didn’t respond to treatment was 6 (15.8%). Follow-up period was 4.2-87.3 months. (mean 42.9). 34 (89.5%) out of 38 patients are alive, 1 (2.6%) died from progression, and three died from other causes. The 5-year overall survival rate was 82.1%, cancer-specific survival rate was 97.0%, and disease-free survival rate was 81.1%. Among the factors significantly (p < 0.05) influencing relapse-free survival: depth of invasion < 5 mm (p – 0.013) and the presence of leukoplakia (p – 0.007). When assessing cancer-specific survival, factors worsening the prognosis were: age >70 years (p – 0.034) and the presence of leukoplakia (p – 0.007). Photodynamic therapy is an alternative treatment method of oral cancer superficial lesions, in case of proper assessment of primary lesion and in case of possibility of full irradiation of the tumor. Moreover, after using photodynamic therapy, the underlying connective-muscular structures are preserved, which promotes rapid healing with minimal scarring, the functions of the affected organ remain intact, and cosmetic defects do not form.
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Affiliation(s)
- Y. A. Panaseykin
- A. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation
| | - V. N. Kapinus
- A. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation
| | - E. V. Filonenko
- P. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation
| | - V. V. Polkin
- A. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation
| | - F. E. Sevrukov
- A. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation
| | | | - P. A. Isaev
- A. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation
| | - S. A. Ivanov
- A. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation; Peoples Friendship University of Russia (RUDN University)
| | - A. D. Kaprin
- P. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation; Peoples Friendship University of Russia (RUDN University); National Medical Research Radiological Center of the Ministry of Health of the Russian Federation
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Al-Aroomi MA, Al-Worafi NA, Ma Y, Alkebsi K, Mohamed AAS, Jiang C. Patient-reported outcomes after oral cancer reconstructions with radial and ulnar forearm-free flaps. Oral Dis 2024. [PMID: 38696366 DOI: 10.1111/odi.14968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVES This study aimed to evaluate patient-reported quality of life and incidence of decision regret in patients undergoing radial (RFFF) and ulnar forearm-free flaps (UFFF) reconstruction. MATERIALS AND METHODS Patients undergoing either RFFF or UFFF were assessed with the University of Washington Quality of Life (UW-QOL) and Oral Health Impact Profile (OHIP-14) questionnaires, and the Decision Regret Scale (DRS), both before and at least 12 months post-reconstruction. RESULTS In total, 40 RFFF and 40 UFFF were included. Harvesting time was longer in RFFF (p = 0.043), and the donor-site defect was significantly larger in RFFF than in UFFF (p = 0.044). Patients with UFFF scored better UW-QOL in the appearance, pain, activity, mood, and social functioning domains (p < 0.05). However, the RFFF group excelled in swallowing and chewing domains. The DRS score revealed a significant difference between RFFF and UFFF, with scores of 36.26 versus 27.36, respectively. Moreover, the mean DRS score reduced at 12 months compared with 6 months, significantly superior for UFFF. CONCLUSION Oral cancer patients reconstructed with UFFF exhibited a better appearance, social domain, and mild decision regret compared with RFFF, indicating that the UFFF may contribute to improving postoperative quality of life in oral cancer patients.
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Affiliation(s)
- Maged Ali Al-Aroomi
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
- Faculty of Dentistry, Ibb University, Ibb, Yemen
| | | | - Yujie Ma
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
| | | | | | - Canhua Jiang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
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Gosselin LE, Villemure-Poliquin N, Audet N. Quality of Life After Head and Neck Cancer Surgery and Free Flap Reconstruction: A Systematic Review. J Otolaryngol Head Neck Surg 2024; 53:19160216241248666. [PMID: 38888940 PMCID: PMC11155320 DOI: 10.1177/19160216241248666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/03/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Different factors can affect the quality of life of patients treated for head and neck cancer undergoing major surgical intervention. However, it remains unclear which specific factors and what possible interventions could have the greatest influence on quality of life postoperatively for patients undergoing surgical resection with free flap reconstruction. The objective of our systematic review was to identify which factors, at the time of surgical treatment, are associated with a worse postoperative quality of life for patients undergoing surgical resection with free flap reconstruction for head and neck cancer. METHODS We performed a systematic review of MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), from their inception through November 2021. We included peer reviewed studies that evaluated the impact of specific factors on quality of life for adult patients who underwent surgery with free flap reconstruction for head and neck cancer. Two reviewers independently screened citations for eligibility and extracted data. Risk of bias of each study was evaluated using the New-Castle Ottawa Scale. Vote counting and qualitative review were used to synthesize results. All relevant findings were reported. RESULTS We initially identified 1971 articles. We included 22 articles in our systematic review, totaling 1398 patients. There was a high level of variability for factors evaluated throughout studies and many studies presented small sample sizes. However, some factors were associated with worse long-term quality of life, including older age, radiotherapy, higher tumor stage, dysphagia, anxiety as well as depressive symptoms. Very few articles analyzed their data for specific tumor subsites and the impact of psychosocial factors was rarely evaluated throughout studies. CONCLUSIONS For patients with head and neck cancer requiring free flap reconstruction, some specific factors may correlate with changes in quality of life. However, these findings are based on very few and mostly underpowered studies. A better understanding of factors affecting quality of life could allow a more personalized and overall better quality of care for patients.
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Affiliation(s)
- Laura-Elisabeth Gosselin
- Department of Ophthalmology and Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Noémie Villemure-Poliquin
- Department of Ophthalmology and Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Nathalie Audet
- Department of Ophthalmology and Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
- Department of Surgery, Service of Otorhinolaryngology—Head and Neck Surgery, Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC, Canada
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Gaxiola-García MA, Kushida-Contreras BH, Albornoz CR, Manrique OJ. Quality of life assessment after microvascular head and neck reconstruction: a systematic review of available tools. Br J Oral Maxillofac Surg 2024; 62:23-29. [PMID: 38042715 DOI: 10.1016/j.bjoms.2023.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/13/2023] [Accepted: 10/26/2023] [Indexed: 12/04/2023]
Abstract
In this study, we aimed to appraise the quality and psychometric properties of quality of life (QOL) assessment tools used after microsurgical reconstruction for head and neck cancers. A systematic review of QOL assessment tools used in head and neck cancer patients after microsurgical reconstruction was performed; emphasis was placed on psychometric properties and validity. Fifty-four studies published between January 2010 and February 2023 fulfilled the criteria; in these, twenty-three different QOL assessment tools were identified. The most commonly used instrument was the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck version (EORTC-H&N). No assessment tool fulfilled all the quality criteria; no single tool presented evidence from all the components of validity. Almost all reported reliability coefficients were above 0.7; most papers reported an internal consistency coefficient (Cronbach's alpha) for the global score. The array of available tools allows for the choice of the most appropriate one depending on the context faced by the clinician or researcher.
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Affiliation(s)
- Miguel Angel Gaxiola-García
- Plastic and Reconstructive Surgery Department, Mexico's Children Hospital (Hospital Infantil de México "Federico Gómez"), Mexico City, Mexico.
| | | | | | - Oscar J Manrique
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, NY, United States
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Tirelli G, Boscolo-Rizzo P, Pelloso L, Gardenal N, Giudici F, Marcuzzo AV, Tofanelli M. Impact of time-to-surgery on survival and quality of life in oral cancer. Am J Otolaryngol 2023; 44:103984. [PMID: 37437337 DOI: 10.1016/j.amjoto.2023.103984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE To investigate the association between time-to-surgery (TTS) and overall survival (OS), disease specific survival (DSS) and quality of life (QoL) in patients with oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS 116 patients with OSCC candidate to surgery were examined. TTS intervals starting from diagnosis (TTS-clinical-based) and from histological reports (TTS-biopsy-based) were calculated. The effects of TTS intervals and prognostic factors on 5-year OS and DSS were explored. RESULTS In our cohort advanced T-categories OSCCs with TTS < 30 days showed a trend to have higher DSS rate (p = 0.049). Patients with TTS-clinical-based < 30 days showed better postoperative QoL. Positive surgical margins, nodal involvement (pN+), DOI >10 mm, invasive surgery and extra-capsular extension in pN+ were found to be significantly associated with a poor OS and DSS. CONCLUSIONS TTS ≥ 30 days can adversely affect DSS, especially in the advanced T categories. Short TTS intervals resulted associated with a better postoperative QoL.
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Affiliation(s)
- Giancarlo Tirelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Ludovica Pelloso
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Nicoletta Gardenal
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Fabiola Giudici
- Department of Medicine, Surgery and Health Sciences, Biostatistics Unit, University of Trieste, Trieste, Italy
| | - Alberto Vito Marcuzzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Margherita Tofanelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy.
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Misra SR, Das R, Karthikeyan R. Quality of life in patients with oral squamous cell carcinoma: A critical assessment tool, sadly ignored! Oral Oncol 2023; 145:106528. [PMID: 37499328 DOI: 10.1016/j.oraloncology.2023.106528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Affiliation(s)
- Satya Ranjan Misra
- Oral Medicine & Radiology, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, India.
| | - Rupsa Das
- Oral Medicine & Radiology, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, India
| | - Ramalingam Karthikeyan
- Department of Oral Pathology & Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Andersen LP, Dietrich MS, Murphy BA, Deng J. Factors associated with quality of life among patients with a newly diagnosed oral cavity and oropharyngeal cancer. Eur J Oncol Nurs 2023; 66:102384. [PMID: 37611502 PMCID: PMC10786603 DOI: 10.1016/j.ejon.2023.102384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 06/07/2023] [Accepted: 07/01/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE The objectives of this report were 1) to examine the quality of life (QOL) of patients with a newly diagnosed oral cavity or oropharyngeal (OCOP) cancer; and 2) to examine factors contributing to QOL before cancer treatment. METHODS The sample included 115 participants with a new diagnosis of OCOP cancer. Participants completed the demographic form, oral cancer disease and treatment form, Hospital Anxiety and Depression Scale (HADS), Brief Health Literacy Screen (BHLS), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Pearson correlations and linear regressions were used for data analysis. RESULTS Participants had a median global health related QOL score of 66.7 (interquartile range, IQR = 50.0, 83.4) with median scores for the subdomains being generally high (all >80 of possible 100). Anxiety and depression were significantly inversely correlated with all areas of EORTC QOL (r = - 0.48 to -0.78, all p < .001). Multivariable associations were strongest with the physical functioning domain (R = 0.56, p < .001), with younger age, higher income, Stage I/II cancer (compared to Stage III/IV) significant contributors to the multiple correlation (beta > ± 0.20, p < .05). CONCLUSIONS Health care providers should be attentive to OCOP cancer patients with older age, lower household income, advanced cancer stage, and presence of anxious and/or depressive symptoms for indicators of poor QOL. CLINICIANS SHOULD CONSIDER THE BENEFIT OF: initiating supportive interventions before cancer treatment among OCOP cancer patients with poor QOL.
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Affiliation(s)
- Lucy P Andersen
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Mary S Dietrich
- Vanderbilt University, Department of Biostatistics, Schools of Medicine & Nursing, Nashville, TN, USA.
| | - Barbara A Murphy
- Vanderbilt Medical Center, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Jie Deng
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA.
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12
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Leuke Bandara D, Kanmodi KK, Salami AA, Amzat J, Jayasinghe RD. Quality of life of dental patients treated with laser surgery: A scoping review. Health Sci Rep 2023; 6:e1368. [PMID: 37351458 PMCID: PMC10283030 DOI: 10.1002/hsr2.1368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/23/2023] [Accepted: 06/11/2023] [Indexed: 06/24/2023] Open
Abstract
Background and Aims The use of lasers has been increasing in various surgical procedures. Its specific characteristics have conquered the scalpel used to a major extent in certain surgical procedures. This scoping review aimed to assess the empirical evidence that exists on the quality of life (QoL) of dental patients treated with laser surgery. Methods This scoping review was conducted in accordance with the Arksey and O'Malley's guidelines for scoping reviews. Four electronic databases (PubMed, SCOPUS, CINAHL Complete, and APA PsycInfo) were systematically searched through a stepwise approach, informed by the PEO (Population [P], Exposure [E], and Outcome [O]) framework, to retrieve literatures relevant to the review question. After a two-staged and Rayyan-aided screening process, only those literatures meeting the inclusion criteria were included into the review. From the included literatures, data were extracted, collated, summarized, and presented. Results The literature search retrieved 246 articles, of which only 10 articles were selected according to the inclusion criteria. Five of the studies were from the United Kingdom and three were from Italy. Study designs were either cohort (60%) or randomized controlled trials (40%). A vast variation was observed in the study populations. The used QoL instruments were mostly disease/condition-specific and oral cancer was the most reported disease in the included articles. The patients who underwent laser surgery had better QoL on the 7th day postoperatively, although it was not significant in later days. Conclusion Depending on the indication, Laser is a safe surgical approach that could enhance the clinical outcome as well as the QoL of dental patients. Laser effects were more significant in the domain of postoperative pain. Due to the limited number of studies evaluated in this review, further longitudinal studies are needed to corroborate the findings of this review.
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Affiliation(s)
| | - Kehinde K. Kanmodi
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- Cephas Health Research Initiative IncIbadanNigeria
| | - Afeez A. Salami
- Department of Oral and Maxillofacial SurgeryUniversity College HospitalIbadanNigeria
| | - Jimoh Amzat
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
- Department of SociologyUniversity of JohannesburgJohannesburgSouth Africa
| | - Ruwan D. Jayasinghe
- Department of Oral Medicine and PeriodontologyUniversity of PeradeniyaPeradeniyaSri Lanka
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Huang K, Przeslawski C, Ramirez CA. What Risk Factors Are Associated With Poorer Quality of Life in Patients With Head and Neck Cancer? J Oral Maxillofac Surg 2023; 81:648-653. [PMID: 36549654 DOI: 10.1016/j.joms.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/02/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Head and neck cancer (HNCA), as well as the sequelae of its treatment, has a significant negative impact on the quality of life (QOL) for patients. We aim to identify patient and surgical factors negatively influencing QOL of patients with HNCA. MATERIALS AND METHODS A cross-sectional study was used to identify specific risk factors associated with a poorer QOL. The University of Michigan Head and Neck Quality of Life (HNQOL) instrument was used to assess QOL. Predictor variables included risk factors (smoking, alcohol, past medical history), demographic (sex, age, marital status), anatomical features (tumor location, tumor stage), perioperative adjuncts (utilization of a feeding tube, tracheostomy, neck dissection), and postoperative adjuncts (chemotherapy or radiation therapy utilization). The primary outcome variable was the HNQOL score. Descriptive statistics were completed for all the variables. Association between the predictor variables and HNQOL scores were examined using bivariate statistics, and statistical significance was set at P < .05. RESULTS The study sample composed of 78 patients with HNCA who underwent surgery at Head and Neck Maxillofacial and Reconstructive Surgery Clinic at Ascension Macomb-Oakland from January 2017 to August 2018. Of the 78 patients meeting inclusion, 31 patients completed the HNQOL survey. The median HNCA QOL score was 18 with a maximum score of 80, representing a worse QOL. Radiation therapy (21 vs 5.5, P = .033), and perioperative feeding tube (31 vs 9, P = .012) had statistically significant negative impacts on QOL scores. Variables associated with poorer QOL scores in descending order: radiation therapy perioperative feeding tube utilization of chemotherapy (12.5 vs 9.0, P = .60), male gender (17 vs 9.5, P = .39), perioperative tracheostomy (26 vs 14.5 P = .26), tobacco use (19.5 vs 11.5, P = .81), single marital status (27 vs 16, P = .48), neck dissection (17.5 vs 15.5, P = .91), and alcohol use (18.5 vs 16.0, P = .65). CONCLUSIONS Feeding tube and radiotherapy utilization had a statistically significant decrease of QOL scores among patients with HNCA. Additional risk factors associated with poorer QOL include chemotherapy, male sex, tracheostomy utilization, tobacco use, single or divorced marital status, neck dissection, and alcohol abuse.
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Affiliation(s)
- Kevin Huang
- Resident, Division of Oral/Maxillofacial Surgery, St John Ascension Hospital
| | | | - Carlos A Ramirez
- Program Director, Oral and Maxillofacial Surgery/Fellowship director Head and Neck Microvascular Surgery, St John Ascension Hospital, Detroit, Michigan.
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14
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Pamias-Romero J, Saez-Barba M, de-Pablo-García-Cuenca A, Vaquero-Martínez P, Masnou-Pratdesaba J, Bescós-Atín C. Quality of Life after Mandibular Reconstruction Using Free Fibula Flap and Customized Plates: A Case Series and Comparison with the Literature. Cancers (Basel) 2023; 15:cancers15092582. [PMID: 37174048 PMCID: PMC10177401 DOI: 10.3390/cancers15092582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/18/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
A single-center retrospective study was conducted to assess health-related quality of life (HRQoL) in 23 consecutive patients undergoing mandibular reconstruction using the computer-aided design (CAD) and computer-aided manufacturing (CAM) technology, free fibula flap, and titanium patient-specific implants (PSIs). HRQoL was evaluated after at least 12 months of surgery using the University of Washington Quality of Life (UW-QOL) questionnaire for head and neck cancer patients. In the 12 single question domains, the highest mean scores were found for "taste" (92.9), "shoulder" (90.9), "anxiety" (87.5), and "pain" (86.4), whereas the lowest scores were observed for "chewing" (57.1), "appearance" (67.9), and "saliva" (78.1). In the three global questions of the UW-QOL questionnaire, 80% of patients considered that their HRQoL was as good as or even better than it was compared to their HRQoL before cancer, and only 20% reported that their HRQoL had worsened after the presence of the disease. Overall QoL during the past 7 days was rated as good, very good or outstanding by 81% of patients, respectively. No patient reported poor or very poor QoL. In the present study, restoring mandibular continuity with free fibula flap and patient-specific titanium implants designed with the CAD-CAM technology improved HRQoL.
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Affiliation(s)
- Jorge Pamias-Romero
- Service of Oral and Maxillofacial Surgery, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain
- CIBBM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Reserca (VHIR), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, E-08035 Barcelona, Spain
| | - Manel Saez-Barba
- Service of Oral and Maxillofacial Surgery, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain
- CIBBM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Reserca (VHIR), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, E-08035 Barcelona, Spain
| | - Alba de-Pablo-García-Cuenca
- Service of Oral and Maxillofacial Surgery, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain
- CIBBM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Reserca (VHIR), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, E-08035 Barcelona, Spain
| | - Pablo Vaquero-Martínez
- Service of Oral and Maxillofacial Surgery, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain
- CIBBM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Reserca (VHIR), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, E-08035 Barcelona, Spain
| | - Joan Masnou-Pratdesaba
- Radiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain
| | - Coro Bescós-Atín
- Service of Oral and Maxillofacial Surgery, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain
- CIBBM-Nanomedicine, Noves Tecnologies i Microcirurgia Craniofacial, Vall d'Hebron Institut de Reserca (VHIR), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, E-08035 Barcelona, Spain
- Unitat Docent Vall d'Hebron, Facultat de Medicina UAB, Universitat Autònoma de Barcelona, E-08035 Barcelona, Spain
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Megee F, Gough K, Frowen J, Dixon B, Magarey M, Wiesenfeld D, Ramakrishnan A. Predictors of distress associated with altered appearance and function in people treated surgically for oral cancers: a cross-sectional study. Int J Oral Maxillofac Surg 2023:S0901-5027(23)00007-3. [PMID: 36739204 DOI: 10.1016/j.ijom.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/14/2022] [Accepted: 01/11/2023] [Indexed: 02/05/2023]
Abstract
This cross-sectional study was performed to examine sources of variation in distress associated with altered appearance and fundamental functions in oral cancer patients at 2 months, 12-15 months, 24-36 months, and ≥ 5 years post-definitive treatment. Eligible patients completed six scales from the FACE-Q Head and Neck Cancer Module. Pre-specified regression models were used to examine sources of variation in study outcomes for 145 patients. Patient self-reports indicated that distress associated with altered appearance and fundamental functions was highly variable, and distress was present beyond 5 years post-definitive treatment in some patients. Associations between distress scores and time post-definitive treatment, reconstructive surgery, and adjuvant therapy were not statistically significant. There was, however, moderate to strong evidence against the null hypothesis of no association between eating distress scores and sex, primary cancer site, and T-stage; smiling distress scores and age and primary cancer site; appearance distress scores and geographical remoteness and primary cancer site; and speaking distress scores and primary cancer site. Primary cancer site was the only significant independent predictor of multiple distress scores. These findings suggest that predicting the psychological impact of oral cancer treatment remains a challenge for the multidisciplinary team. Screening and interventions for psychological distress are essential beyond the preoperative and acute care settings.
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Affiliation(s)
- F Megee
- Speech Pathology and Audiology Department, The Royal Melbourne Hospital, Victoria, Australia.
| | - K Gough
- Department of Health Services Research, Peter MacCallum Cancer Centre, Victoria, Australia; Department of Nursing, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Victoria, Australia
| | - J Frowen
- Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia
| | - B Dixon
- Department of Surgery, The University of Melbourne, Victoria, Australia; Department of Cancer Surgery, Peter MacCallum Cancer Centre, Victoria, Australia
| | - M Magarey
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Victoria, Australia; Department of Medical Education, The University of Melbourne, Victoria, Australia
| | - D Wiesenfeld
- Department of Surgery, The University of Melbourne, Victoria, Australia; Head and Neck Tumour Stream, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Victoria, Australia
| | - A Ramakrishnan
- Department of Surgery, The University of Melbourne, Victoria, Australia; Department of Plastic and Reconstructive Surgery, The Royal Melbourne Hospital, Victoria, Australia
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16
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Garner SJ, Patel S, Pollard AJ, Jerreat MP. Post-treatment evaluation of oral health-related quality of life in head and neck cancer patients after dental implant rehabilitation. Br Dent J 2023:10.1038/s41415-023-5460-2. [PMID: 36693964 DOI: 10.1038/s41415-023-5460-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/10/2022] [Indexed: 01/25/2023]
Abstract
Objectives To assess oral health-related quality of life (OHRQoL) following oral rehabilitation using dental implants in patients treated for head and neck cancer (HNC).Materials and methods Service evaluation: patients who had received dental implants during their oral rehabilitation were invited to take part (n = 81). In total, 37 patients completed questionnaires and underwent a structured interview regarding OHRQoL after rehabilitation. Analysis was by descriptive statistics for questionnaire and thematic analysis of interview.Results Rehabilitation types were 17 fixed implant prostheses, 12 removable implant prostheses and 8 combination. Functional problems relating to HNC treatment had a significant effect on OHRQoL and persisted after rehabilitation. Removable implant prostheses had more problems associated than fixed. At interview, patients described: functional and emotional benefits of oral rehabilitation involving implants; ease of keeping implants clean; variations in ability of primary care dentists to maintain rehabilitation; thankfulness to have received treatment; long duration of rehabilitation; and problems encountered while undergoing rehabilitation.Conclusions HNC treatment results in functional and emotional difficulties, which has a significant impact on OHRQoL. Use of dental implants in fixed or removable oral rehabilitation can result in good OHRQoL as assessed by patients at treatment completion, although some functional difficulties often remain.
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Affiliation(s)
- Sarah J Garner
- Specialty Registrar, Restorative Dentistry, Musgrove Park Hospital, Taunton, UK; Musgrove Park Hospital, Taunton, UK.
| | - Sapna Patel
- Specialty Training Registrar, Restorative Dentistry, Croydon University Hospital and Guy´s Hospital, London, UK
| | - Alexander J Pollard
- Specialty Registrar, Restorative Dentistry, Musgrove Park Hospital, Taunton, UK; Musgrove Park Hospital, Taunton, UK
| | - Matthew P Jerreat
- Consultant in Restorative Dentistry, Musgrove Park Hospital, Taunton, UK; Associate Professor, Restorative Dentistry, Plymouth University Peninsula School of Dentistry, Plymouth, UK
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Amina BS, Anshul S, Sharan TK, Anusha RS, Lewis S, Umesh V, Priyanka A, Tarun G. Radiation Therapy Treatment Outcomes for Patients with Head and Neck Cancer: a Tertiary Care Centre Experience in a Tier Three Town. Indian J Otolaryngol Head Neck Surg 2022; 74:6146-6150. [PMID: 36742778 PMCID: PMC9895132 DOI: 10.1007/s12070-021-02810-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/08/2021] [Indexed: 02/07/2023] Open
Abstract
To report the outcomes of patients with head and neck squamous cell cancers (HNSCC) who received radiotherapy as a part of their first line treatment. All patients treated with radiotherapy for HNSCC between 2013 and 2017 were retrospectively identified from the department records. Patients with follow-up of less than 3 months following primary treatment were excluded. The demographic, disease and outcome details were retrieved from the patients' hospital records. The disease free survival (DFS) was estimated with Kaplan-Meier analysis, and effect of different variables on DFS were compared using log-rank test. The late toxicities of treatment were also recorded and reported. A total of 311 patients were found to be eligible. Most patients were males (82%), and oral cavity cancers predominated (45.3%). 237 patients (76.2%) had locally advanced disease at presentation. Radiotherapy was used as definitive treatment for 152 patients (48.9%). At a median follow up of 14.8 months (range: 3-85.2 months), the estimated Disease-Free Survival (DFS) was 52.7 months (95%CI: 37.7-67.7 months). Locally advanced disease correlated with a significantly lower median DFS (61.2 vs. 32.8 months; p = 0.01), but other factors, including gender, use of concurrent chemotherapy and adjuvant vs definitive radiotherapy appeared to have no statistical association with DFS. 181 (58.2%) patients had chronic RT-related toxicities at last follow-up, but most were generally mild, most frequently subcutaneous fibrosis (48.6%, which occurred significantly more frequently in patients receiving adjuvant RT following surgery- 40.8% versus 57.2%; p = 0.03) and xerostomia (32.4%). Radiation induced osteoradionecrosis was rare, occurring in only three (1%).Most HNSCC patients present with locally advanced disease, where disease control remains poor. Though there is substantial toxicity following treatment, the risk of severe toxicities with modern radiotherapy is low.
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Affiliation(s)
- B. S. Amina
- Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - S. Anshul
- Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - T. K. Sharan
- Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - R. S. Anusha
- Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - Shirley Lewis
- Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - V. Umesh
- Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - A. Priyanka
- Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - G. Tarun
- Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
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Vermaire JA, Partoredjo ASK, de Groot RJ, Brand HS, Speksnijder CM. Mastication in health-related quality of life in patients treated for oral cancer: A systematic review. Eur J Cancer Care (Engl) 2022; 31:e13744. [PMID: 36239005 PMCID: PMC9787816 DOI: 10.1111/ecc.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 09/14/2022] [Accepted: 09/27/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Treatment for oral cancer can impair oral functions such as mastication, which may negatively affect quality of life (QoL). In this review, an overview is provided of masticatory ability in patients treated for oral cancer. METHODS The PubMed (MEDLINE), Embase and Cochrane databases were systematically searched for scientific literature on masticatory ability in relation to QoL in patients treated for oral cancer. Studies were included when oral cancer treatment was provided, and the University of Washington Quality of Life (UW-QoL) questionnaire was used. Risk of bias (MINORS) was independently assessed by two authors. RESULTS The PubMed (MEDLINE), Embase and Cochrane search yielded 575 unique records of which 111 were assessed full text, and 27 studies were included. The UW-QoL mastication scores ranged from 31.9 to 97.4. There was a wide variety in methodology, patient groups, tumour site, treatment and assessment moment, to such a degree that outcome scores are difficult to compare. CONCLUSION The wide variety in studies exploring health-related QoL in relation to mastication in oral cancer patients prevents the identification of possible relations between treatment, masticatory ability and QoL. Our findings underline the limitations in currently available literature and indicate the necessity for more comparable research.
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Affiliation(s)
- Jorine A. Vermaire
- Imaging Division, Department of Radiation Oncology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Abbergayle S. K. Partoredjo
- Department of Oral and Maxillofacial Surgery and Special Dental Care, Department of Head and Neck Surgical Oncology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands,Department of Oral BiochemistryAcademic Centre for Dentistry Amsterdam (ACTA)AmsterdamThe Netherlands
| | - Reilly J. de Groot
- Department of Oral and Maxillofacial Surgery and Special Dental Care, Department of Head and Neck Surgical Oncology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Henk S. Brand
- Department of Oral BiochemistryAcademic Centre for Dentistry Amsterdam (ACTA)AmsterdamThe Netherlands
| | - Caroline M. Speksnijder
- Department of Oral and Maxillofacial Surgery and Special Dental Care, Department of Head and Neck Surgical Oncology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands,Department of Head and Neck Surgical Oncology, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
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van Baar GJC, Lodders JN, Chhangur C, Leeuwrik L, Forouzanfar T, Liberton NPTJ, Berkhout WER, Winters HAH, Leusink FKJ. The Amsterdam UMC protocol for computer-assisted mandibular and maxillary reconstruction; A cadaveric study. Oral Oncol 2022; 133:106050. [PMID: 35914442 DOI: 10.1016/j.oraloncology.2022.106050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/12/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES In this cadaveric study, the accuracy of CAS guided mandibular and maxillary reconstruction including immediate dental implant placement in different Brown defect classes is assessed. MATERIALS AND METHODS The virtual planning and surgical procedure was conducted according to a newly proposed Amsterdam UMC reconstruction protocol. Postoperative evaluation was performed according to a previously proposed evaluation guideline. RESULTS Fourteen mandibular and 6 maxillary reconstructions were performed. Average mandibular angle deviations were 1.52°±1.32, 1.85°±1.58, 1.37°±1.09, 1.78°±1.37, 2.43°±1.52 and 2.83°±2.37, respectively for the left and right axial angles, left and right coronal angles and left and right sagittal angles. A total of 62 dental implants were placed in neomandibles with an average dXYZ values of 3.68 ± 2.21 mm and 16 in neomaxillas with an average dXYZ values of 3.24 ± 1.7 mm. CONCLUSION Promising levels of accuracy were achieved for all mandibular angles. Dental implant positions approached the preoperative preferred positions well, within the margin to manufacture prosthetic devices.
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Affiliation(s)
- Gustaaf J C van Baar
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Johannes N Lodders
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Chayenne Chhangur
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Lars Leeuwrik
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Niels P T J Liberton
- Department of Medical Technology, 3D Innovation Lab, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - W Erwin R Berkhout
- Department of Oral and Maxillofacial Radiology, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Henri A H Winters
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Frank K J Leusink
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Xu Q, Wang SM, Liu YH, Yin SC, Su XZ, Xu ZF. Comparison between the radial forearm and groin soft tissue free flaps for reconstruction in patients with oral cavity cancer: a quality of life analysis. Int J Oral Maxillofac Surg 2022; 51:1289-1295. [DOI: 10.1016/j.ijom.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 04/13/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
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21
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Demoralization in oral cancer inpatients and its association with spiritual needs, quality of life, and suicidal ideation: a cross-sectional study. Health Qual Life Outcomes 2022; 20:60. [PMID: 35366908 PMCID: PMC8976948 DOI: 10.1186/s12955-022-01962-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 03/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background Demoralization is a common problem in oral cancer patients owing to the chronic and severe nature of their affliction. However, the association between demoralization and the patient’s spiritual needs, quality of life, and suicidal ideation remains unclear. This study aims to provide insights into possible links between demoralization among oral cancer patients and its effects on the patient’s spiritual needs, quality of life, and suicidal ideation.
Methods We examined 155 Taiwanese oral cancer inpatients in Taichung Veterans General Hospital, Taiwan, using the following three rating scales: (a) Demoralization Scale Mandarin Version (DS-MV), (b) Spiritual Interests Related to Illness Tool, and (c) The Taiwan Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Suicidal ideation was established if at least one of the two suicide-related items on the DS-MV scale were checked. We divided the participants into high- and low-demoralization groups, per the cutoff score of 30. We then explored group associations with sociodemographic features, quality of life, and spiritual needs. Logistic regression and receiver operating characteristic (ROC) curves were used to determine demoralization and its association between these variables. Results Fifty-five (35.5%) patients were categorized as having high demoralization (DS-MV scale score > 30), with scores for DS-MV for all patients being 27.2 ± 16.8. The rates of suicidal ideation were 29.1% (16/55) in the high-demoralization group and 2% (2/100) in the low-demoralization group, with an odds ratio (95% confidence interval) of 20.10 (4.41–91.55). Logistic regression analysis revealed significant effects of spiritual needs and global health status on the DS-MV scores (p < 0.001). Multivariate analyses further confirmed that only overall quality of life scores < 62.5 and spiritual needs < 3.7 significantly predicted the occurrence of high demoralization. Conclusion High demoralization is associated with low satisfaction with spiritual needs, poor quality of life, and high risk of suicidal ideation. DS-MV may potentially be an effective tool for achieving holistic health care among oral cancer patients.
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Truscott A, Zamani R, Akrami M. Comparing the use of conventional and three-dimensional printing (3DP) in mandibular reconstruction. Biomed Eng Online 2022; 21:18. [PMID: 35305669 PMCID: PMC8934485 DOI: 10.1186/s12938-022-00989-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background There are a number of clinical disorders that require mandibular reconstruction (MR). Novel three-dimensional (3D) printing technology enables reconstructions to be more accurate and beneficial to the patient. However, there is currently no evidence identifying which techniques are better suited for MR, based on the type of clinical disorder the patient has. In this study, we aim to compare 3D techniques with conventional techniques to identify how best to reconstruct the mandible based on the clinical cause that necessitates the reconstructive procedure: cancerous or benign tumours, clinical disorders, infection or disease and trauma or injury. Methods PubMed, Scopus, Embase and Medline were searched to identify relevant papers that outline the clinical differences between 3D and conventional techniques in MR. Data were evaluated to provide a clear outline of suitable techniques for surgery. Results 20 of 2749 papers met inclusion criteria. These papers were grouped based on the clinical causes that required MR into four categories: malignant or benign tumour resection; mandibular trauma/injury and other clinical disorders. Conclusions The majority of researchers favoured 3D techniques in MR. However, due to a lack of standardised reporting in these studies it was not possible to determine which specific techniques were better for which clinical presentations.
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Jehn P, Linsen SS, Zeller AN, Eckstein FM, Neuhaus MT, Gellrich NC, Krüskemper G, Lentge F, Spalthoff S, Korn P. Gender-specific differences concerning psychosocial aspects and functional impairments that influence quality of life in oral cancer treatment. Support Care Cancer 2022; 30:4905-4915. [PMID: 35171323 DOI: 10.1007/s00520-022-06907-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Patients with oral cancer have gender-specific differences with respect to health-related quality of life (HRQoL) and psychosocial variables (PV). The aim of the present study was to evaluate HRQoL and PV outcomes in patients treated for oral squamous cell carcinoma. METHODS Data of 1234 patients were collected from a multicenter rehabilitation study of the German-Austrian-Swiss Cooperative Group on Tumours of the Maxillofacial Region (DÖSAK). Patient characteristics, oncological variables, post-treatment impairments, general quality of life (QoL), and PV (coping strategies, control beliefs, personal traits, perceived social support, depression, anxiety, and fear of tumor recurrence) were recorded. RESULTS After treatment, HRQoL was similar between genders concerning general QoL, but men experienced significantly more treatment-related functional impairments influencing HRQoL. PV revealed gender-specific coping strategies, with women reporting significantly more "depressive coping," "religiosity," "fatalistic externality," and higher "social burden." Owing to their religious coping strategies, fatalistic attitude, and perceived higher social integration, women demonstrated superior disease acceptance, despite higher depression, anxiety, and lower psychosocial resilience. Conversely, men reported more introverted personal traits and lower social integration. CONCLUSION Interventions during oral cancer treatment should address PV and have gender-specific elements to improve HRQoL after therapy.
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Affiliation(s)
- Philipp Jehn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany.
| | - Sabine Swantje Linsen
- Department of Prosthodontics; Preclinical Education and Dental Material Science, University Hospital Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
| | - Alexander-Nicolai Zeller
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Fabian Matthias Eckstein
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Michael-Tobias Neuhaus
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, University Hospital of Leipzig, Liebigstr. 12, Leipzig, 04103, Germany
| | - Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Gertrud Krüskemper
- Department of Medical Psychology, Ruhr University of Bochum, Universitätsstr. 150, Building MA 0/145, 44780, Bochum, Germany
| | - Fritjof Lentge
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Simon Spalthoff
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Philippe Korn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
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Quality of health assessment in oral cancer patients postoperatively – A retrospective study. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2021.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Oswald LB, Brownstein NC, Whiting J, Hoogland AI, Saravia S, Kirtane K, Chung CH, Vinci C, Gonzalez BD, Johnstone PAS, Jim HSL. OUP accepted manuscript. Oncologist 2022; 27:e176-e184. [PMID: 35641215 PMCID: PMC8895733 DOI: 10.1093/oncolo/oyab029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/29/2021] [Indexed: 11/15/2022] Open
Abstract
Background Cigarette smoking is related to greater cancer incidence, worse cancer-related clinical outcomes, and worse patient quality of life. Few studies have evaluated the role of smoking in patients’ experiences of cancer-related symptom burden. This study examined relationships between smoking and total symptom burden as well as the incidence of severe symptoms among adult cancer patients. Patients and Methods Patients at Moffitt Cancer Center completed self-report surveys as part of routine cancer care. Symptom burden was evaluated as the sum of individual symptom ratings (total symptom burden) and the number of symptoms rated severe (incidence of severe symptoms). Zero-inflated negative binomial modeling was used to evaluate the relationships between smoking status (ever vs never smoker) and symptom burden outcomes controlling for relevant sociodemographic and clinical covariates and accounting for the proportion of participants reporting no symptom burden. Results This study included 12 571 cancer patients. More than half reported a history of cigarette smoking (n = 6771, 55%). Relative to never smokers, participants with a smoking history had 15% worse expected total symptom burden (ratio = 1.15, 95% confidence interval [CI] 1.11-1.20, P < .001) and 13% more expected severe symptoms (ratio = 1.13, 95% CI 1.05-1.21, P = .001) above and beyond the effects of relevant sociodemographic and clinical characteristics. Conclusion Results provide support that smoking is associated with worse cancer symptom burden. More research is needed to evaluate how smoking history (ie, current vs former smoker) and smoking cessation influence cancer symptom burden.
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Affiliation(s)
- Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Corresponding author: Laura B. Oswald, PhD, Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, MFC-EDU, Tampa, FL 33612, USA. Tel: 813-745-1338;
| | - Naomi C Brownstein
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Junmin Whiting
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Sabrina Saravia
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Kedar Kirtane
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Christine H Chung
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Christine Vinci
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
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Jimenez JE, Nilsen ML, Gooding WE, Anderson JL, Khan NI, Mady LJ, Wasserman-Wincko T, Duvvuri U, Kim S, Ferris RL, Solari MG, Kubik MW, Johnson JT, Sridharan S. Surgical factors associated with patient-reported quality of life outcomes after free flap reconstruction of the oral cavity. Oral Oncol 2021; 123:105574. [PMID: 34715452 DOI: 10.1016/j.oraloncology.2021.105574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/17/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To determine which surgical factors are associated with quality-of-life (QOL) outcomes in oral cavity cancer survivors after free flap reconstruction of the oral cavity. PATIENTS AND METHODS A cross-sectional study was conducted from a multidisciplinary head and neck cancer (HNC) survivorship clinic. Oral cavity cancer survivors with at least 6-months of postoperative follow-up from ablation and free flap reconstruction were included. Primary outcome measures were validated patient-reported outcome measures (PROMs) including the Eating Assessment Tool-10 (EAT-10) measure of swallowing-specific QOL, University of Washington Quality of Life (UW-QOL) physical and social-emotional subscale scores and feeding tube dependence. RESULTS Extent of tongue resection was associated with EAT-10 and the UW-QOL Physical subscale scores. Patients with oral tongue defects reported worse scores than with composite defects in the EAT-10 and UW-QOL physical domain (p = 0.0004, 0.0025, respectively). This association no longer applies when controlling for differences in extent of tongue resection. Patients with anterior composite resections reported worse EAT-10 scores than lateral resections (p = 0.024). This association no longer applies when controlling for extent of tongue resection (p = 0.46). Gastric tube dependence demonstrates similar trends to PROMs. CONCLUSION Extent of tongue resection was strongly associated with poor QOL outcomes after free tissue reconstruction of the oral cavity and mediates the associations between other defect characteristics and QOL. These findings demonstrate the need for emphasis on expected oral tongue defects when counseling patients and highlight the need to address QOL in a multidisciplinary fashion post-operatively.
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Affiliation(s)
- Joaquin E Jimenez
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States
| | - Marci Lee Nilsen
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States; University of Pittsburgh, School of Nursing, Department of Acute and Tertiary Care, United States
| | | | - Jennifer L Anderson
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States
| | - Nayel I Khan
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States
| | - Leila J Mady
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, United States
| | - Tamara Wasserman-Wincko
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States
| | - Umamaheswar Duvvuri
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States
| | - Seungwon Kim
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States
| | - Robert L Ferris
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States; UPMC Hillman Cancer Center, United States
| | - Mario G Solari
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States; Department of Plastic Surgery, University of Pittsburgh Medical Center, United States
| | - Mark W Kubik
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States; Department of Plastic Surgery, University of Pittsburgh Medical Center, United States
| | - Jonas T Johnson
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States
| | - Shaum Sridharan
- Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, United States; Department of Plastic Surgery, University of Pittsburgh Medical Center, United States.
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Jehn P, Spalthoff S, Lentge F, Zeller AN, Tavassol F, Neuhaus MT, Eckstein FM, Krüskemper G, Gellrich NC, Korn P. Postoperative quality of life and therapy-related impairments of oral cancer in relation to time-distance since treatment. J Cancer Surviv 2021; 16:1366-1378. [PMID: 34609700 DOI: 10.1007/s11764-021-01118-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/30/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE Oral cancer resection can cause physical and psychological impairments that influence the quality of life (QoL). Depending on the postoperative time-distance, the occurrence and intensity of these impairments may change. We evaluated the sequelae and changes in therapy-related impairments during the postoperative course to detect associations between the time since surgery and the presence of disorders. METHODS Data from a questionnaire completed by 1359 patients who underwent surgical treatment of oral squamous cell carcinoma and were involved in a multicenter rehabilitation study of the German-Austrian-Swiss Cooperative Group on Tumors of the Maxillofacial Region (DÖSAK) that included 43 oral and maxillofacial clinics in Germany, Austria, and Switzerland were retrospectively analyzed. RESULTS Physical impairments, including those in appearance, mouth opening ability, ability to smell, gastric disorders, mandible mobility, breathing, and shoulder/arm mobility, were significantly associated with and increased with time-distance since surgery. Esthetic appearance most strongly correlated with the highest perception of worsening. Regarding psychological disorders, worry about tumor recurrence, depression, and worse prospects were significantly associated. Among the postoperative sequelae, fear of tumor recurrence decreased continuously; however, depression and worse prospects increased. The general QoL did not significantly differ overall during the postoperative course. CONCLUSIONS Therapy-related impairments change during the postoperative course based on the time-distance since surgery. The general QoL may not markedly vary; however, single impairments, to some extent, can increase or decrease. IMPLICATIONS FOR CANCER SURVIVORS Continuous adaptation of supportive cancer therapy is required during follow-up to sufficiently address individual treatment needs.
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Affiliation(s)
- Philipp Jehn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Simon Spalthoff
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Fritjof Lentge
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Alexander-Nicolai Zeller
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Frank Tavassol
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Michael-Tobias Neuhaus
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Fabian Matthias Eckstein
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Gertrud Krüskemper
- Department of Medical Psychology, Ruhr University of Bochum, Bochum, Germany
| | - Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Philippe Korn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Bschorer M, Schneider D, Goppold K, Sperling J, Schön G, Bschorer R. Quality of life and survival rate after primary surgical treatment of oral squamous cell carcinoma: A retrospective study with 18 years of follow-up. J Craniomaxillofac Surg 2021; 50:170-177. [PMID: 34625373 DOI: 10.1016/j.jcms.2021.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/25/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022] Open
Abstract
The aim of this study is to evaluate the long-term survival rates and assess the long-term quality of life (QoL) of patients treated for oral squamous cell carcinoma (OSCC). Patients, who underwent primary surgical tumor resection for OSCC at a single hospital center in Germany between 1998 and 2016, were eligible for inclusion in this analysis of survival rates and QoL parameters. The University of Washington-QoL version 4 (UW-QoL v4) questionnaire was administered to the patients in the years 2015 and 2016. The cases of 145 patients with the histological diagnosis of OSCC were included in this study. Despite a common distribution of tumor stage, the 1-year survival rate was 88.0% and the 5-year survival rate was 70.0%. The QoL questionnaire item, 'pain' (84) was selected most frequently. Chewing (50) and swallowing (58) yielded the lowest score. Chewing and swallowing impairment correlated significantly with an increase in tumor size, higher tumor stages, and the use of radio (chemo-)therapy (p < 0.001). In this retrospective study, patients reported significant long-term dysphagia and difficulty chewing. These parameters should be investigated in prospective studies to evaluate methods that could reduce the risk of suffering from these impairments.
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Affiliation(s)
- Maximilian Bschorer
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Germany.
| | - Daniel Schneider
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Germany
| | - Kai Goppold
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Germany
| | - Juliane Sperling
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Germany
| | - Gerhard Schön
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Reinhard Bschorer
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Germany
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De Cicco D, Tartaro G, Ciardiello F, Fasano M, Rauso R, Fiore F, Spuntarelli C, Troiano A, Lo Giudice G, Colella G. Health-Related Quality of Life in Oral Cancer Patients: Scoping Review and Critical Appraisal of Investigated Determinants. Cancers (Basel) 2021; 13:cancers13174398. [PMID: 34503208 PMCID: PMC8431462 DOI: 10.3390/cancers13174398] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 12/27/2022] Open
Abstract
Simple Summary Oral cancer may strongly impair patients’ quality of life. Huge efforts have been made during recent decades in trying to improve the treatment outcomes in terms of patients’ survival, self-perception, and satisfaction. Consequently, the investigation into health-related quality of life (HRQOL) became an established and worldwide practice. Hundreds of studies tried to clarify which could be the most important variables that impact HRQOL in head and neck cancer patients. However, such a complex topic may be influenced by a multitude of interconnected aspects and several controversies were reported. In this study the current literature was reviewed to identify all those possible sources of bias that may be encountered in trying to correlate HRQOL to patient-specific or disease/treatment-specific aspects. As a result, a list of recommendations was reported to enhance the evidence of future studies. 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.
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Affiliation(s)
- Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
| | - Gianpaolo Tartaro
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (R.R.); (G.C.)
| | - Fortunato Ciardiello
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.C.); (M.F.)
| | - Morena Fasano
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.C.); (M.F.)
| | - Raffaele Rauso
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (R.R.); (G.C.)
| | - Francesca Fiore
- Department of Internal and Polyspecialist Medicine, A.O.U. “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Chiara Spuntarelli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
| | - Antonio Troiano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
- Correspondence:
| | - Giorgio Lo Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
| | - Giuseppe Colella
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (R.R.); (G.C.)
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Yuwanati M, Gondivkar S, Sarode SC, Gadbail A, Desai A, Mhaske S, Pathak SK, N Khatib M. Oral health-related quality of life in oral cancer patients: systematic review and meta-analysis. Future Oncol 2021; 17:979-990. [PMID: 33541115 DOI: 10.2217/fon-2020-0881] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: The purpose of this meta-analysis was to evaluate the impact of oral health on quality of life in oral cancer patients (OCPs). Methods: PubMed, Scopus and Web of Science databases were searched for publications on oral health-related quality of life (OHRQoL) in OCP and the information was extracted according to the PRISMA guidelines. A random effect model was used to obtain the pooled standard mean differences of Oral Health Impact Profile (OHIP)-14 questionnaire responses in meta-analysis. Results: total of 12 research papers were analyzed and revealed poor OHRQoL in OCPs (standard mean difference: 2.53; 95% CI: 1.55-3.50; p < 0.00001) compared with healthy individuals due to the effects of oncotherapy. Moreover, OHRQoL deteriorated with combinations of different treatment modalities. Conclusion: Oral health and oncotherapy can affect the quality of life in OCPs.
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Affiliation(s)
- Monal Yuwanati
- Department of Oral & Maxillofacial Pathology, People's College of Dental Sciences & Research Centre, People's University, Bhopal, 462037, Madhya Pradesh, India
| | - Shailesh Gondivkar
- Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, 440009, Maharashtra, India
| | - Sachin C Sarode
- Department of Oral Pathology & Microbiology, Dr DY Patil Dental College & Hospital, Dr DY Patil Vidyapeeth, Pune, 411018, Maharashtra, India
| | - Amol Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, 440018, Maharashtra, India
| | - Ami Desai
- Department of Oral & Maxillofacial Pathology, People's College of Dental Sciences & Research Centre, People's University, Bhopal, 462037, Madhya Pradesh, India
| | - Shubhangi Mhaske
- Department of Oral & Maxillofacial Pathology, People's College of Dental Sciences & Research Centre, People's University, Bhopal, 462037, Madhya Pradesh, India
| | - Sandeep K Pathak
- Central Library, Indian Institutes of Science Education & Research, Bhopal, 462006, Madhya Pradesh, India
| | - Mahalaqua N Khatib
- Division of Evidence Synthesis, School of Epidemiology & Public Health, Datta Meghe Institute of Medical Sciences (DU), Wardha, 442004, Maharashtra, India
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Gondivkar SM, Gadbail AR, Sarode SC, Hedaoo A, Dasgupta S, Sharma B, Sharma A, Gondivkar RS, Yuwanati M, Patil S, Gaikwad RN. Oral and general health-related quality of life in oral squamous cell carcinoma patients- comparative analysis of different treatment regims. J Oral Biol Craniofac Res 2021; 11:125-131. [PMID: 33532199 DOI: 10.1016/j.jobcr.2021.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/24/2020] [Accepted: 01/02/2021] [Indexed: 10/22/2022] Open
Abstract
Background Modern aggressive oncological treatment options for oral squamous cell carcinoma (OSCC) are inevitably associated with impaired general health-related quality of life (HRQoL) and oral HRQoL (OHRQoL). However, there is dire need for prospective and concomitant assessment of HRQoL and OHRQoL after different treatment regims. Hence, present study was designed to investigate HRQoL and OHRQoL in patients treated for OSCC using various modalities. Methods 135 OSCC patients were grouped according to treatment rendered into Group A: surgery only; Group B: post-surgical radiotherapy (PRT); and Group C: post-surgical chemo-radiation (PCRT). The 12-item Short Form Health Survey (SF-12) and Oral Health Impact Profile-14 (OHIP-14) were intervened to assess HRQoL and OHRQoL respectively at 1-month and 6-months post-treatment. Results At 1-month post-treatment, patients who received PCRT showed significantly lower mean values for physical and mental domains of SF-12 and higher mean subscales and overall OHIP-14 (24.57 ± 2.62) score than those treated by surgery alone (10.55 ± 2.26) and PRT (20.20 ± 3.80), with largest differences between PCRT and surgery alone groups (p < 0.001). Social functioning, general health and bodily pain of SF-12 and functional limitations, physical pain and physical disability amongst OHIP-14 domains were greatly affected. Although few physical domains of SF-12 showed significant improvement, mental domains remained a greater problem after 6 months. However, OHRQoL was significantly poor in all the three study groups (p < 0.001). Conclusion Irrespective of the post-treatment duration, patients who received PCRT had worse HRQoL and OHRQoL. There is a need to identify factors associated with impaired HRQoL and OHRQoL to customize better therapeutic decisions.
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Affiliation(s)
- Shailesh M Gondivkar
- Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Amol R Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra State, India
| | - Sachin C Sarode
- Department of Oral Pathology & Microbiology, Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra State, India
| | - Amol Hedaoo
- RST Cancer Hospital & Research Centre (Tertiary Care Cancer Centre), Nagpur, Maharashtra State, India
| | - Subhrajit Dasgupta
- RST Cancer Hospital & Research Centre (Tertiary Care Cancer Centre), Nagpur, Maharashtra State, India
| | - Balkrishna Sharma
- RST Cancer Hospital & Research Centre (Tertiary Care Cancer Centre), Nagpur, Maharashtra State, India
| | - Aparna Sharma
- Department of Dentistry, Government Medical College & Hospital, Nagpur, Maharashtra State, India
| | - Rima S Gondivkar
- # 301, Aarti Regency, Mahalakshmi Nagar, Manewada Road, Nagpur, Maharashtra State, India
| | - Monal Yuwanati
- Department of Oral Pathology & Microbiology, People's College of Dental Sciences & Research Centre, People's University, Bhopal, Madhya Pradesh, India
| | - Shankargouda Patil
- Department of Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Rahul N Gaikwad
- Department of Community Dentistry and Oral Epidemiology, College of Dentistry, Qassim University, Buraydah, Saudi Arabia
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Colella G, Rauso R, De Cicco D, Boschetti CE, Iorio B, Spuntarelli C, Franco R, Tartaro G. Clinical management of squamous cell carcinoma of the tongue: patients not eligible for free flaps, a systematic review of the literature. Expert Rev Anticancer Ther 2020; 21:9-22. [PMID: 33081545 DOI: 10.1080/14737140.2021.1840359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The management of squamous cell carcinoma (SCC) of the tongue represents the most demanding treatment planning in head and neck surgery. Ablation followed by free flap reconstruction is considered the gold standard, but not all patients are suitable for this strategy. The aim of this review is to provide a comprehensive view of surgical reconstruction possibilities in patients not eligible for free flaps. METHODS Following PRISMA recommendations, a systematic literature review was conducted searching for original papers that investigated outcomes of patients treated by surgical ablation for tongue SCC followed by reconstruction with local or pedicled flaps. Selected papers were read and data extracted for qualitative analysis. RESULTS Twenty articles met the inclusion/exclusion criteria. The study design was case series in sixteen papers, cohort study in the remaining four. Four different local flaps (BMM, FAMM, NLIF, SMIF) and four regional flaps have been discussed in included studies (IHF, SFIF, SCM, PMMC). CONCLUSION The improved anatomical knowledge makes local flaps a reliable alternative to free tissue transfer in cases requiring small-/medium-sized defects. Regional flaps still represent cornerstones in reconstruction of the tongue. Ease of execution, costs-to-benefit ratio, low-rate complications, minimal donor site morbidity represent the best advantages choosing local/regional flaps.
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Affiliation(s)
- Giuseppe Colella
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Raffaele Rauso
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II" , Naples, Italy
| | - Ciro Emiliano Boschetti
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II" , Naples, Italy
| | - Brigida Iorio
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II" , Naples, Italy
| | - Chiara Spuntarelli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II" , Naples, Italy
| | - Renato Franco
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli" , Naples, Italy
| | - Gianpaolo Tartaro
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli" , Naples, Italy
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A pilot study of masticatory function after maxillectomy comparing rehabilitation with an obturator prosthesis and reconstruction with a digitally planned, prefabricated, free, vascularized fibula flap. J Prosthet Dent 2020; 124:616-622. [DOI: 10.1016/j.prosdent.2019.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 06/20/2019] [Accepted: 06/20/2019] [Indexed: 12/29/2022]
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Alqahtani M, Nahhas A, Malibari L, Alghamdi M, Bazuhier S, Abdulrahman S, Aboalshamat K, Salama R. Awareness of Oral Cancer Among Dental Patients in Mecca, Saudi Arabia. Open Dent J 2020. [DOI: 10.2174/1874210602014010369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Oral Cancer (OC) is a serious health problem affecting the oral cavity, which may lead to death. Alcohol, tobacco, and chewing betel are the main risk factors. Early diagnosis and adequate knowledge of OC may improve the survival rate.
Objective:
This study aimed to assess the knowledge about oral cancer among dental patients in Mecca.
Methods:
A cross-sectional study was conducted in the dental clinics of Mecca. Interviewer-administered questionnaires were distributed to 416 respondents aged 18 or older, who spoke Arabic or English, had no history of OC, and participated voluntarily. The questionnaire consisted of three sections. The first regarded demographical data, the second measured knowledge about OC, and the third was concerned with education regarding OC provided by health-care providers. The interviewers also educated the participants by handing brochures with information about OC.
Results:
Knowledge about OC among dental patients in Mecca was found to be significantly low. Only 102 of the 416 participants (24.5%) had any knowledge. Only 3.4% of all participants had been educated about OC by their health-care providers.
Conclusion:
The results of this study show a considerable lack of general knowledge about OC among dental patients in Mecca. Health programs should be developed to raise the community’s awareness.
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Goiato MC, Amoroso AP, Silva B, Dos Santos EG, Caxias FPD, Bitencourt SB, Moreno A, Dos Santos DM. The Impact of Surgery and Radiotherapy on Health-Related Quality of Life of Individuals with Oral and Oropharyngeal Carcinoma and Short-Term Follow up after Treatment. Asian Pac J Cancer Prev 2020; 21:1227-1234. [PMID: 32458626 PMCID: PMC7541871 DOI: 10.31557/apjcp.2020.21.5.1227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Indexed: 11/25/2022] Open
Abstract
Objective: This study aimed to evaluate the quality of life of patients with oral or oropharyngeal cancer by using specific questionnaires (QLQ-C30 and QLQ-HandN35), varying according to the location of the tumor (oral cavity or oropharynx) and the treatment performed (only surgery or surgery associated with radiotherapy). Methods: Fifty patients were enrolled in this study and answered the EORTC QLQ-C30 and EORTC HandN35 questionnaires, before (baseline), at 1 week, and 3 months after treatment. Internal consistency reliability was calculated with the Cronbach coefficient. The Kruskal-Wallis and Wilcoxon tests were applied and P<.05 was considered significant. Results: Some aspects showed significant difference (P<.05) between tumor location (oral/oropharyngeal) and treatment performed (surgery or surgery plus radiotherapy) only for the baseline and 1 week after treatment periods. Conclusion: Quality of life is a factor that affected patients with head and neck cancer. The time elapsed after treatment, whether surgical or surgical plus radiotherapy, influenced patient quality of life. The period of greatest morbidity was 1 week after treatment.
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Affiliation(s)
- Marcelo Coelho Goiato
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Andressa Paschoal Amoroso
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Bruna Silva
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Emerson Gomes Dos Santos
- Department of Business, Paulista School of Politics, Economics and Business, Universidade Federal de São Paulo (UNIFESP), Osasco, Brazil
| | - Fernanda Pereira De Caxias
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Sandro Basso Bitencourt
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Amalia Moreno
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Daniela Micheline Dos Santos
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
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Dholam K, Chouksey G, Dugad J. Impact of Oral Rehabilitation on Patients with Head and Neck Cancer: Study of 100 Patients with Liverpool Oral Rehabilitation Questionnaire and the Oral Health Impact Profile. Indian J Otolaryngol Head Neck Surg 2020; 72:308-312. [PMID: 32728540 DOI: 10.1007/s12070-020-01801-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 01/22/2020] [Indexed: 11/25/2022] Open
Abstract
Prosthodontic rehabilitation enables head and neck cancer patient to optimally restore function, thereby improving and enhancing the oral health related quality of life of cancer patients. The liverpool oral rehabilitation questionnaire (LORQ-v3) and oral health impact profile (OHIP) are specific tools that measure OHRQOL. Hundred patients with head and neck cancer were included in the study. Patients were asked to rate their experience of dental problems before fabrication of prosthesis and after 1 year using LORQv3 and OHIP-14. The responses were compared on Likert scale. There were extreme problems reported by head and neck cancer patients before dental rehabilitation. After 1 year of prosthetic rehabilitation, there was improvement noticed in all the domain of LORQ-v3 and OHIP-14. Complete compliance to the use of prosthetic appliances for 1 year study period was noted. For all the items of LORQ-v3 there was 10 to 38% improvement in function. OHIP-14 showed an 11 to 26% improvements in all the domains. Prosthetic rehabilitation contributed to an improvement of patients with head and neck cancer, in view of the decreased scores on the Likert scale after prosthetic treatment. The study of hundred patients with head and neck cancer showed that the oral health-related quality of life improved after prosthodontic rehabilitation.
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Affiliation(s)
- Kanchan Dholam
- Department of Dental and Prosthetic Services, Tata Memorial Hospital, Mumbai, Dr. E Borges Road, Parel, Mumbai, 400012 India
| | - Gunjan Chouksey
- Department of Dentistry, All India Institute of Medical Sciences, Bhopal, Saket Nagar, Bhopal, Madhya Pradesh 462020 India
| | - Jinesh Dugad
- Somaiya Ayurvihar Behind Everard Nagar, Asian Cancer Institute, Mumbai, Off Eastern Express Hwy, Sion East, Mumbai, Maharashtra 400022 India
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Brondani MA, Siqueira AB, Alves CMC. Exploring lay public and dental professional knowledge around HPV transmission via oral sex and oral cancer development. BMC Public Health 2019; 19:1529. [PMID: 31729969 PMCID: PMC6858745 DOI: 10.1186/s12889-019-7923-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 11/08/2019] [Indexed: 11/18/2022] Open
Abstract
Background Human papillomavirus (HPV) has been associated with certain types of oropharyngeal cancers and yet, the level of knowledge that dental professionals and the lay public have in terms of HPV transmission, oral sexual activities, and oral cancer development needs exploration. The aim of this study was to assess the knowledge held by practicing dental professionals as well as the lay public regarding Human Papillomavirus (HPV) transmission through oral sex and subsequent oropharyngeal cancer development. Methods Textual data were collected from a public forum with dental professionals in. Vancouver, who discussed the HPV-oral sex-oral cancer triad, and from survey data gathered from 212 lay public participants (also in Vancouver) who answered a 13-item questionnaire on the perceived risks of oral sex in terms of HPV infection and oropharyngeal cancer development. The data were analyzed statistically by age group, gender, and sexual orientation using descriptive statistics, while an ANOVA test was used to compare variation in the responses to the survey (p-value = 0.05). Results The forum engaged 46 health care professionals, many of whom were aware of the potential risks for head and neck cancer development due to HPV infection, while also questioning “how to effectively talk about HPV with patients.” The survey revealed that 34.5% of the participants believed that oral sex is an activity with no or low risk for the transmission of HPV, while 84% of participants believed the same sexual practices were of low or no-risk for HIV (Human Immunodeficiency Virus) transmission. Most participants (82%) never discussed oral sexual activities with their physicians or dentists/dental hygienists. Conclusions The general public remains mostly unaware of the potential links between HPV infection and oropharyngeal cancer. Physicians and dental providers should discuss oral sexual practice with their patients to raise awareness.
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Affiliation(s)
- Mario A Brondani
- Division of Dental Public Health. Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, V6T 1Z3, BC, Canada.
| | | | - Claudia Maria Coelho Alves
- Department of Dentistry II, Federal University of Maranhão, Av. dos Portugueses, 1966 - Vila Bacanga, CEP- 65080-805, São Luis-Maranhão, Brazil
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Ge X, Liao Z, Yuan J, Mao D, Li Y, Yu E, Wang X, Ding Z. Radiotherapy-related quality of life in patients with head and neck cancers: a meta-analysis. Support Care Cancer 2019; 28:2701-2712. [PMID: 31673782 DOI: 10.1007/s00520-019-05077-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 09/10/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare effects of intensity-modulated radiotherapy (IMRT) with those of conventional radiotherapy on quality of life (QoL) and severity of xerostomia in patients with head and neck cancer. MATERIAL AND METHODS PubMed, Cochrane, and Embase databases were searched to July 1, 2019, to identify relevant studies, using the following terms: radiotherapy, head and neck cancer, quality of life, cognition, xerostomia, two-/three-dimensional conformal radiation therapy, IMRT, conformal proton beam radiation therapy, stereotactic radiosurgery, and volumetric modulated arc therapy. The outcomes of interest were QoL measured by global health status; emotional, social, and cognitive function; and severity of xerostomia. RESULTS Seven studies with a total of 761 patients (n = 369 with IMRT; n = 392 with conventional RT) were included in this study. Median patient age was 18-65 years. IMRT group patients had better global health status (pooled standardized mean difference [SMD] = 0.80, 95% CI 0.26 to 1.35, P = 0.004) and cognitive function (pooled SMD = 0.30, 95% CI 0.06 to 0.54, P = 0.013) than the conventional RT group. Patients receiving IMRT also had significantly lower scores for xerostomia than those receiving conventional RT (pooled SMD = - 0.60, 95% CI - 0.97 to - 0.24, P = 0.001). No differences were found in emotional function (P = 0.531) and social function (P = 0.348) between the two groups. CONCLUSION IMRT significantly improves QoL and reduces the severity of xerostomia in patients with head and neck cancer. Results of this study provide clinicians with guidelines for decisions on the use of IMRT versus conventional RT.
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Affiliation(s)
- Xiuhong Ge
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 261 Huansha Rd, Hangzhou, 310006, China
| | - Zhengluan Liao
- Department of Psychiatry, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, 158 Shangtang Rd, Hangzhou, 310014, China
| | - Jianhua Yuan
- Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, 158 Shangtang Rd, Hangzhou, 310014, China
| | - Dewang Mao
- Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, 158 Shangtang Rd, Hangzhou, 310014, China
| | - Yumei Li
- Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, 158 Shangtang Rd, Hangzhou, 310014, China
| | - Enyan Yu
- Department of Psychiatry, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, 158 Shangtang Rd, Hangzhou, 310014, China.
| | - Xunheng Wang
- College of Life Information Science and Instrument Engineering, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Zhongxiang Ding
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 261 Huansha Rd, Hangzhou, 310006, China.
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Quality of life of patients with head and neck cancer after prophylactic percutaneous-gastrostomy. Eur J Clin Nutr 2019; 74:565-572. [PMID: 31570758 DOI: 10.1038/s41430-019-0499-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND HNC patients often experience weight loss during treatment. To date, there is only limited data on patient quality of life (QLQ) and subjective benefit of the PEG insertion. OBJECTIVE To investigate the nutritional status, QLQ, and overall benefit. METHODS 181 patients fitting our inclusion criteria (01/2012-12/2012) were enrolled. Utilization rate, nutritional status, QLQ, and subjective PEG assessment were determined with electronic charts and the Quality of life-questionnaire (EORTC-QLQ-C30). RESULTS The utilization rate of the entire cohort was 91.7%. The PEG was used full-time by 149 patients. No statistical differences in QLQ were observed between the groups. Of the patients that used the PEG entirely (99.7%), partially (85.3%) or not all (55.3%) would 99.7%, 85.3 and 55.8% undergo the procedure in the future if necessary. CONCLUSIONS QLQ was not significantly reduced by insertion. Especially patients using the PEG full-time had an objective and subjective benefit from the inserted PEG tube.
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Tashimo Y, Ihara Y, Yuasa K, Nozue S, Saito Y, Katsuta H, Shimane T, Takahashi K. Acute Stage Longitudinal Change of Quality of Life from Pre- to 3 Months after Surgical Treatment in Head and Neck Cancer Patients. Asian Pac J Cancer Prev 2019; 20:3129-3136. [PMID: 31653164 PMCID: PMC6982687 DOI: 10.31557/apjcp.2019.20.10.3129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Head and neck cancer (HNC) patients experience various posttreatment side effects that decrease quality of life (QOL). Some previous study reported that QOL of HHC patients were returned baseline (before treatment) after a year post treatment. However, acute stage longitudinal changes of QOL in HNC patients remains unclear. This point might be important for early reintegration of HNC patients. This study aimed to investigate the acute stage longitudinal change of the relationship between QOL and oral function in HNC patients had surgery. METHODS 45 HNC patients (23 men) scheduled for surgical treatment were enrolled in this study. Primary tumor sites were 22 tongue, 5 maxilla, 4 mandible, 3 pharynx and others. Weight, body mass index (BMI), whole body soft lean mass (SLM), and skeletal muscle mass (SMM) were evaluated as muscle mass-related measurements. Lip closure force (LC) and tongue pressure (TP) were evaluated as oral function measurements. Feeding function was evaluated using the Functional Oral Intake Scale (FOIS). QOL was assessed using the European Organization for Research and Treatment of Cancer QOL Questionnaire QLQ-C30 and H&N 35. Measures were evaluated at pre-surgical treatment (PT), and 1 month (1M) and 3 months (3M) after surgery. The change of QOL parameters and relationships between measurements were assessed. RESULTS For QOL assessments, role functioning, fatigue, speech problems, trouble with social eating, trouble with social contact, and opening mouth significantly decreased from PT to 1M, but significantly increased from 1M to 3M. Weight, BMI, SLM, SMM, LC, TP, and FOIS demonstrated significant relationships with QOL from PT to 1M. Meanwhile, from 1M to 3M, weight, BMI, SLM, SMM, LC, and FOIS showed significant relationships with QOL assessments. CONCLUSIONS Both oral function and muscle mass-related measurements significantly affected QOL in HNC patients.
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Affiliation(s)
- Yuichi Tashimo
- Division of Oral Rehabilitation Medicine, Department of Special Needs Dentistry, Showa University, School of Dentistry, Tokyo, Japan
| | - Yoshiaki Ihara
- Division of Oral Rehabilitation Medicine, Department of Special Needs Dentistry, Showa University, School of Dentistry, Tokyo, Japan
| | - Ken Yuasa
- Division of Oral Rehabilitation Medicine, Department of Special Needs Dentistry, Showa University, School of Dentistry, Tokyo, Japan
| | - Shinji Nozue
- Division of Oral Rehabilitation Medicine, Department of Special Needs Dentistry, Showa University, School of Dentistry, Tokyo, Japan
| | - Yoshiro Saito
- Head and Neck Oncology Center, Showa University Hospital, Tokyo, Japan
| | - Hideyuki Katsuta
- Head and Neck Oncology Center, Showa University Hospital, Tokyo, Japan
| | - Toshikazu Shimane
- Head and Neck Oncology Center, Showa University Hospital, Tokyo, Japan
| | - Koji Takahashi
- Division of Oral Rehabilitation Medicine, Department of Special Needs Dentistry, Showa University, School of Dentistry, Tokyo, Japan
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Rehabilitation after maxillectomy in patients with implant-retained obturator: A preliminary report. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:8-13. [PMID: 31562033 DOI: 10.1016/j.oooo.2019.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/19/2019] [Accepted: 08/26/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the clinical outcomes of implant-retained obturator rehabilitation after maxillectomy, based on quality of life (QOL) and masticatory function. STUDY DESIGN The present study included 12 patients who underwent dental implant surgery after maxillectomy. Oral health-related QOL and masticatory function before and after completion of implant-retained obturator rehabilitation were evaluated. RESULTS Oral Health Impact Profile-Short Form (OHIP-14) scores showed significant differences in the domain for functional limitation (before, 4.08 ± 2.47; after, 1.33 ± 0.98; P < .01); physical pain (before, 2.75 ± 2.05; after, 0.42 ± 0.51; P < .01); physical disability (before, 3.24 ± 2.11; after, 1.33 ± 1.30; P < .01), psychological disability (before, 3.83 ± 2.48; after, 1.67 ± 2.50; P < .01); social disability (before, 2.17 ± 1.75; after, 1.08 ± 1.38; P < .05); handicap (before, 3.17 ± 1.90; after, 1.08 ± 1.00; P < .01); and total score (before, 22.41 ± 10.17; after, 8.83 ± 6.82; P < .01) Furthermore, masticatory function score was significantly higher after completing implant-retained obturator rehabilitation (before, 38.75 ± 22.97; after, 69.17 ± 21.41; P < .01). CONCLUSIONS Implant-retained obturator rehabilitation contributed to improved masticatory function and oral health-related QOL after maxillectomy.
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Wang S, Yin S, Zhang ZL, Su X, Xu ZF. Quality of Life After Oral Cancer Resection and Free Flap Reconstruction. J Oral Maxillofac Surg 2019; 77:1724-1732. [DOI: 10.1016/j.joms.2019.02.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/14/2019] [Accepted: 02/14/2019] [Indexed: 12/24/2022]
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Peterson CE, Gordon SC, Le Hew CW, Dykens JA, Jefferson GD, Tampi MP, Urquhart O, Lingen M, Watson KS, Buscemi J, Fitzgibbon ML. Society of Behavioral Medicine position statement: Society of Behavioral Medicine supports oral cancer early detection by all healthcare providers. Transl Behav Med 2019; 9:819-822. [PMID: 30007335 PMCID: PMC7184875 DOI: 10.1093/tbm/iby075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Indexed: 11/12/2022] Open
Abstract
In response to the increasing incidence of certain oral and oropharyngeal cancers, the Society of Behavioral Medicine (SBM) calls on healthcare providers and legislators to expand awareness of oral and oropharyngeal cancer risk factors, increase early detection, and support policies that increase utilization of dental services. SBM supports the American Dental Association's 2017 guideline for evaluating potentially malignant oral cavity disorders and makes the following recommendations to healthcare providers and legislators. We encourage healthcare providers and healthcare systems to treat oral exams as a routine part of patient examination; communicate to patients about oral/oropharyngeal cancers and risk factors; encourage HPV vaccination for appropriate patients based on recommendations from the Advisory Committee on Immunization Practices; support avoidance of tobacco use and reduction of alcohol consumption; and follow the current recommendations for evaluating potentially malignant oral cavity lesions. Because greater evidence is needed to inform practice guidelines in the primary care setting, we call for more research in collaborative health and dental services. We encourage legislators to support policies that expand Medicaid to cover adult dental services, increase Medicaid reimbursement for dental services, and require dental care under any modification of, or replacement of, the Affordable Care Act.
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Affiliation(s)
- Caryn E Peterson
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, USA
| | - Sara C Gordon
- School of Dentistry, University of Washington, Seattle, WA, USA
| | - Charles W Le Hew
- College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - J A Dykens
- Center for Global Health and College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | | | - Mark Lingen
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | | | | | - Marian L Fitzgibbon
- Institute for Health Research and Policy and Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
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Meier JK, Schuderer JG, Zeman F, Klingelhöffer C, Hullmann M, Spanier G, Reichert TE, Ettl T. Health-related quality of life: a retrospective study on local vs. microvascular reconstruction in patients with oral cancer. BMC Oral Health 2019; 19:62. [PMID: 31029131 PMCID: PMC6487048 DOI: 10.1186/s12903-019-0760-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/09/2019] [Indexed: 01/24/2023] Open
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.
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Affiliation(s)
- J K Meier
- Department of Oral and Maxillofacial Surgery, University Medical Center Regensburg, 93042, Regensburg, Germany.
| | - J G Schuderer
- Department of Oral and Maxillofacial Surgery, University Medical Center Regensburg, 93042, Regensburg, Germany
| | - F Zeman
- Center for Clinical Studies, University Medical Center Regensburg, Regensburg, Germany
| | - Ch Klingelhöffer
- Department of Oral and Maxillofacial Surgery, University Medical Center Regensburg, 93042, Regensburg, Germany
| | - M Hullmann
- Department of Oral and Maxillofacial Surgery, University Medical Center Regensburg, 93042, Regensburg, Germany
| | - G Spanier
- Department of Oral and Maxillofacial Surgery, University Medical Center Regensburg, 93042, Regensburg, Germany
| | - T E Reichert
- Department of Oral and Maxillofacial Surgery, University Medical Center Regensburg, 93042, Regensburg, Germany
| | - T Ettl
- Department of Oral and Maxillofacial Surgery, University Medical Center Regensburg, 93042, Regensburg, Germany
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A Comparison of Immediate and Delayed Dental Implant Placement in Head and Neck Surgery Patients. J Oral Maxillofac Surg 2019; 77:1156-1164. [PMID: 30851250 DOI: 10.1016/j.joms.2019.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 02/05/2019] [Accepted: 02/05/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE Implant-supported dental prostheses offer numerous benefits for patients after ablative procedures of the head and neck region, including restoration of function, improved self-esteem and body satisfaction, and overall quality of life. Increased experience is emerging with immediate placement of implants at the time of ablative surgery compared with the traditional delayed approach. The authors sought to identify variables affecting survival of osseointegrated dental implants in such patients and to assess the impact of timing of implant insertion (immediate vs delayed) on the time until final prosthesis insertion. MATERIALS AND METHODS Implant survival was assessed based on different factors: immediate versus delayed implants, benign versus malignant disease, postoperative radiotherapy, smoking status, alcohol status, age, 1- versus 2-stage surgery, hyperbaric oxygen therapy, and implant placement into native bone versus into osseous free flap reconstruction. Time to final prosthesis insertion was compared between immediate and delayed implant placement. RESULTS The study included 20 patients who received a total of 102 implants (39 immediate, 63 delayed). There were 7 failed implants (overall survival, 93.14%). There was no statistically relevant difference in implant survival between any of the groups assessed. However, there was a significant decrease in time to final prosthesis insertion for those patients receiving immediate implants compared with those who underwent delayed implant placement (321 days; standard error, 46.5 vs 726 days; standard error, 45 days; P < .0001). CONCLUSIONS Immediate implant placement is an effective approach to the prosthetic rehabilitation of patients undergoing ablative procedures of the jaws, which shortens time to final prosthesis placement without adversely affecting overall implant survival.
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Petrosyan V, Kane G, Ameerally P. Oral Cancer Treatment Through the Ages: Part 2. J Oral Maxillofac Surg 2019; 77:1484-1489. [PMID: 30794811 DOI: 10.1016/j.joms.2019.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/17/2018] [Accepted: 01/15/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Understanding how oral cancer treatment evolved can pave the way for future management. The literature holds an expansive collection of historical findings regarding oral cancer, yet the authors were unable to find a comprehensive review of oral cancer treatment throughout the ages. MATERIALS A thorough literature review was carried out using multiple scientific databases and languages, as well as examination of historical archives. Articles were included for their relevance and their findings were assimilated. RESULTS Part two of this article considers the development of specific surgical concepts relating to head and neck cancer over the previous two centuries, including neck dissection and reconstruction, as well as exploration of non-surgical cancer therapies. CONCLUSION This paper demonstrates historical landmarks made in oral cancer treatment and the prominent figures who pioneered them, confirming that head and neck cancer surgeons of today have valuable lessons to learn from their previous counterparts.
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Affiliation(s)
- Vahe Petrosyan
- Oral and Maxillofacial Surgery Trainee, Northampton General Hospital, Cliftonville, United Kingdom
| | - Georgina Kane
- Dental Core Trainee, Northampton General Hospital, Cliftonville, United Kingdom.
| | - Phillip Ameerally
- Consultant Oral and Maxillofacial Head and Neck Surgeon, Northampton General Hospital, Cliftonville, United Kingdom
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Ovsyannikov SA, Dzhangildin YT, Slabkovskaya AB, Arhangelskaya AS, Gadzhieva UH. The significance of the dynamics of anxiety-depressive indicators and quality of life in patients with dental anomalies in assessing the effectiveness of orthodontic treatment. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:88-92. [DOI: 10.17116/jnevro20191191288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Grote M, Maihöfer C, Weigl M, Davies-Knorr P, Belka C. Progressive resistance training in cachectic head and neck cancer patients undergoing radiotherapy: a randomized controlled pilot feasibility trial. Radiat Oncol 2018; 13:215. [PMID: 30400971 PMCID: PMC6219249 DOI: 10.1186/s13014-018-1157-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer cachexia is a prevalent symptom of head and neck neoplasms. The reduction in skeletal muscle mass is one of the main characteristics which can lead to poor physical functioning. The purposes of this pilot randomized controlled trial were to determine the feasibility of progressive resistance training in cachectic head and neck cancer patients during radiotherapy and to explore possible risks and benefits. METHODS Twenty cachectic participants with head and neck cancer receiving radiation were randomized to obtain either a machine supported progressive resistance training (n = 10) or usual care (n = 10). The training took place 3 times weekly for 30 min. Intervention included 3 exercises for major muscle groups with 8-12 repetition maximum for 3 sets each. Bioelectrical impedance analysis, hand-held dynamometry, Six-Minute Walk Test and standardized questionnaires for fatigue and quality of life were used for evaluating outcomes at baseline before radiotherapy (t1), after 7 weeks of radiotherapy (t2) and 8 weeks after the end of radiotherapy (t3). RESULTS All participants (n = 20) completed the trial. No serious adverse events occurred. At the initial assessment the cachectic patients had already lost 7.1 ± 5.2% of their body weight. General fatigue (score 10.7 ± 3.3) and reduced quality of life (score 71.3 ± 20.6) were prevalent in cachectic head and neck cancer patients even before radiotherapy. An average improvement of weight loading for leg press (+ 19.0%), chest press (+ 29.8%) and latissimus pull-down (+ 22.8%) was possible in the intervention group. Participants had at least 13 training sessions. The outcome measures showed nonsignificant changes at t2 and t3, but a trend for a better course of general fatigue and quality of life at t2 in the intervention group. CONCLUSIONS Despite advanced tumor stage and burdensome treatment the intervention adherence is excellent. Progressive resistance training in cachectic head and neck cancer patients during radiotherapy seems to be safe and feasible and may have beneficial effects of general fatigue and quality of life. TRIAL REGISTRATION ClinicalTrials.gov, NCT03524755 . Registered 15 May 2018 - Retrospectively registered.
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Affiliation(s)
- Manuel Grote
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany. .,Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, 81377, Munich, Germany. .,Present Address: Department of Health Promotion/Occupational Health Management, AOK Baden-Württemberg, 70191, Stuttgart, Germany.
| | - Cornelius Maihöfer
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany.,Clinical Cooperation Group 'Personalized Radiotherapy in Head and Neck Cancer' Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Martin Weigl
- Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Patricia Davies-Knorr
- Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany.,Clinical Cooperation Group 'Personalized Radiotherapy in Head and Neck Cancer' Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
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van Baar GJC, Forouzanfar T, Liberton NPTJ, Winters HAH, Leusink FKJ. Accuracy of computer-assisted surgery in mandibular reconstruction: A systematic review. Oral Oncol 2018; 84:52-60. [PMID: 30115476 DOI: 10.1016/j.oraloncology.2018.07.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/29/2018] [Accepted: 07/10/2018] [Indexed: 11/18/2022]
Abstract
Computer-assisted surgery (CAS) for mandibular reconstruction was developed to improve conventional treatment methods. In the past years, many different software programs have entered the market, offering numerous approaches for preoperative planning and postoperative evaluation of the CAS process of mandibular reconstruction. In this systematic review, we reviewed planning and evaluation methods in studies that quantitatively assessed accuracy of mandibular reconstruction performed with CAS. We included 42 studies describing 413 mandibular reconstructions planned and evaluated using CAS. The commonest software was Proplan/Surgicase CMF (55%). In most cases, the postoperative virtual 3-dimensional model was compared to the preoperative 3-dimensional model, revised to the virtual plan (64%). The commonest landmark for accuracy measurements was the condyle (54%). Accuracy deviations ranged between 0 mm and 12.5 mm and between 0.9° and 17.5°. Because of a lack of uniformity in planning (e.g., image acquisition, mandibular resection size) and evaluation methodologies, the ability to compare postoperative outcomes was limited; meta-analysis was not performed. A practical and simple guideline for standardizing planning and evaluation methods needs to be considered to allow valid comparisons of postoperative results and facilitate meta-analysis in the future.
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Affiliation(s)
- Gustaaf J C van Baar
- Department of Oral and Maxillofacial Surgery/Oral Pathology & 3D Innovation Lab, VU University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology & 3D Innovation Lab, VU University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - Niels P T J Liberton
- Department of Oral and Maxillofacial Surgery/Oral Pathology & 3D Innovation Lab, VU University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - Henri A H Winters
- Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - Frank K J Leusink
- Department of Oral and Maxillofacial Surgery/Oral Pathology & 3D Innovation Lab, VU University Medical Centre/Academic Centre for Dentistry Amsterdam (ACTA), De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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Indrapriyadharshini K, Madankumar PD, Karthikeyan GR. Oral health-related quality of life in patients treated for oral malignancy at Kanchipuram district, India: A cross-sectional study. Indian J Cancer 2018; 54:11-15. [PMID: 29199653 DOI: 10.4103/ijc.ijc_116_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The modern-day onco-surgical therapy is now concerned on the overall Quality of Life after treatment of the patient. There is need to evaluate final outcome following the different combination of treatment modalities available to make better therapeutic treatment decisions. AIM The aim of this study was to assess Oral health related quality of life (OHRQoL) in patients with oral malignancies who had undergone various treatments. SETTINGS AND DESIGN A Cross sectional study was conducted among 90 patients between October 2016 to January 2017 in private hospitals, kanchipuram, India. MATERIALS AND METHODS Participants were grouped based on the treatment they had undergone into Group I - Surgery alone, Group II - Surgery and Radiotherapy, Group III- Surgery, chemotherapy and radiotherapy and assessed for OHRQoL using the shorter version of Oral health impact profile -14 (OHIP-14) questionnaire. STATISTICAL ANALYSIS Descriptive analysis of socio demographic variables and OHIP 14 was performed using Chi-square test and one way ANOVA. RESULTS Among the 90 participants, 43.3% belonged to upper lower class and 38.3% to lower class. Buccal mucosa (58.9%) was found to be the most frequent site. Among the clinical staging, Stage II (33.33%) oral cancer was more prevalent. No statistically significant differences in the OHIP mean score for Groups, I, II, III. Among the domains functional limitation was significantly different in the three groups. CONCLUSION Patients with oral malignancies who had been treated surgically alone had better Quality of life when compared to the combined treatment modalities.
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Affiliation(s)
- K Indrapriyadharshini
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, India
| | - P D Madankumar
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, India
| | - G R Karthikeyan
- Department of Oral and Maxillofacial Surgery, Karpaga Vinayaga Institute of Dental Sciences, Kanchipuram, Tamil Nadu, India
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