Alexandre Bozec1, Pierre Demez2, Jocelyn Gal3, Emmanuel Chamorey3, Marie-Yolande Louis4, David Blanchard4, Dominique De Raucourt4, Jean-Claude Merol5, Esteban Brenet5, Olivier Dassonville6, Gilles Poissonnet6, José Santini6, Frédéric Peyrade7, Karen Benezery8, Maria Lesnik9, Etienne Berta10, Pierre Ransy2, Emmanuel Babin11. 1. Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. Electronic address: alexandre.bozec@nice.unicancer.fr. 2. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Liège, Belgium. 3. Department of Statistics, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. 4. Department of Maxillo-facial and Head and Neck Surgery, Centre François-Baclesse, Caen, France. 5. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Reims, France. 6. Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. 7. Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. 8. Department of Radiotherapy, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France. 9. Department of Otorhinolaryngology and Head and Neck Surgery, Institut Curie, Paris, France. 10. Department of Otorhinolaryngology and Head and Neck Surgery, Hospital of Annecy, France. 11. Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Caen, France.
Abstract
OBJECTIVE: To assess long-term quality of life (QoL) and psycho-social outcomes, and to determine their predictive factors after oropharyngeal cancer (OPC) surgery and radial forearm free-flap (RFFF) reconstruction. METHODS: Patients who had undergone OPC surgery and RFFF reconstruction who were still alive and disease-free at least 1 year after surgery were enrolled in this prospective multicentric study. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core (QLQ-C30) and Head and Neck Cancer (QLQ-H&N35) QoL questionnaires, the Voice Handicap Index (VHI-10) questionnaire and the Hospital Anxiety and Depression Scale (HADS). The level of dysphagia was evaluated using the Dysphagia Handicap Index (DHI) and the Dysphagia Outcomes and Severity Scale (DOSS). Predictive factors of these clinical outcomes were determined in univariate and multivariate analysis. RESULTS: A total of 58 patients were included in this study. Long-term QoL and functioning scales scores were well-preserved (all superior to 70%). Main persistent symptoms were fatigue, reduced sexuality and oral function-related disorders (swallowing, teeth, salivary and mouth-opening problems). HADS anxiety and depression scores were 7.2 and 5.4, respectively. Twenty-one (36%) patients presented an anxiodepressive disorder (HADS global score ≥ 15). Among the 21 patients who were still working before surgery, 11 (52%) had returned to work at the time of our study. The HADS global score (p < 0.001) was the main predictor of QoL, VHI-10 and DOSS scores. CONCLUSIONS: Psychological distress is the main determinant of long-term QoL and is therefore of critical importance in the multidisciplinary management of OPC patients.
OBJECTIVE: To assess long-term quality of life (QoL) and psycho-social outcomes, and to determine their predictive factors after oropharyngeal cancer (OPC) surgery and radial forearm free-flap (RFFF) reconstruction. METHODS:Patients who had undergone OPC surgery and RFFF reconstruction who were still alive and disease-free at least 1 year after surgery were enrolled in this prospective multicentric study. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core (QLQ-C30) and Head and Neck Cancer (QLQ-H&N35) QoL questionnaires, the Voice Handicap Index (VHI-10) questionnaire and the Hospital Anxiety and Depression Scale (HADS). The level of dysphagia was evaluated using the Dysphagia Handicap Index (DHI) and the Dysphagia Outcomes and Severity Scale (DOSS). Predictive factors of these clinical outcomes were determined in univariate and multivariate analysis. RESULTS: A total of 58 patients were included in this study. Long-term QoL and functioning scales scores were well-preserved (all superior to 70%). Main persistent symptoms were fatigue, reduced sexuality and oral function-related disorders (swallowing, teeth, salivary and mouth-opening problems). HADS anxiety and depression scores were 7.2 and 5.4, respectively. Twenty-one (36%) patients presented an anxiodepressive disorder (HADS global score ≥ 15). Among the 21 patients who were still working before surgery, 11 (52%) had returned to work at the time of our study. The HADS global score (p < 0.001) was the main predictor of QoL, VHI-10 and DOSS scores. CONCLUSIONS: Psychological distress is the main determinant of long-term QoL and is therefore of critical importance in the multidisciplinary management of OPC patients.
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