Functional and Quality of Life Outcomes After Partial Glossectomy: a Multi-institutional Longitudinal Study of the Head and Neck Research Network

Overview

Journal J Otolaryngol Head Neck Surg

Publisher Sage Publications

Specialties General Surgery
Otorhinolaryngology

Date 2017 Sep 6

PMID 28870248

Citations 26

Authors

Agnieszka Dzioba

Daniel Aalto

Georgina Papadopoulos-Nydam

Hadi Seikaly

Jana Rieger

Johan Wolfaardt

Martin Osswald

Jeffrey R Harris

Daniel A OConnell

Cathy Lazarus

Mark Urken

Ilya Likhterov

Raymond L Chai

Erika Rauscher

Daniel Buchbinder

Devin Okay

Risto-Pekka Happonen

Ilpo Kinnunen

Heikki Irjala

Tero Soukka

Juhani Laine

Affiliations

Soon will be listed here.

Abstract

Background: While aggressive treatment for oral cancer may optimize survival, decrements in speech and swallowing function and quality of life often result. This exploratory study investigated how patients recover their communicative function, swallowing ability, and quality of life after primary surgery [with or without adjuvant (chemo)radiation therapy] for tongue cancer over the course of the first year post-operation.

Methods: Patients treated for oral cancer at three institutions (University of Alberta Hospital, Mount Sinai Beth Israel Medical Center, and Turku University Hospital) were administered patient-reported outcomes assessing speech [Speech Handicap Index (SHI)], swallowing [(M.D. Anderson Dysphagia Inventory (MDADI)] and quality of life [European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC-H&N35)]. Outcome measures were completed pre-operatively and at 1-, 6-, and 12-months post-operatively.

Results: One hundred and seventeen patients undergoing partial glossectomy with reconstruction participated in this study. Results indicated no significant differences in swallowing function (MDADI and EORTC-H&N35 subscales) between baseline and 6 months post-surgery and no significant differences in speech function (SHI subscales) between baseline and 1 year post-surgery. Most quality of life domains (EORTC-H&N35 subscales) returned to baseline levels by 1 year post-operation, while difficulties with dry mouth and sticky saliva persisted. A clear time trend of adjuvant (chemo)radiation therapy negatively affecting dry mouth scores over time was identified in this study, while negative independent effects of chemoradiation on MDADI swallowing, and EORTC-H&N35 swallowing, eating, and opening mouth subscales were found.

Conclusions: Assessment time influenced patient-reported speech, swallowing, and quality of life outcomes, while treatment (by time) effects were found for only swallowing and quality of life outcomes. Results of the present study will help guide clinical care and will be useful for patient counseling on expected short and long-term functional and quality of life outcomes of surgical and adjuvant treatment for oral cavity cancer.

Citing Articles

Epidemiology, Diagnostics, and Therapy of Oral Cancer-Update Review.

Kijowska J, Grzegorczyk J, Gliwa K, Jedras A, Sitarz M Cancers (Basel). 2024; 16(18).

PMID: 39335128 PMC: 11430737. DOI: 10.3390/cancers16183156.

Optimising Patient Outcomes in Tongue Cancer: A Multidisciplinary Approach.

de Boer J, Barnett R, Cardin A, Cimoli M, Davies L, Delany C Cancers (Basel). 2024; 16(7).

PMID: 38610956 PMC: 11010906. DOI: 10.3390/cancers16071277.

Head and neck cancer treatment outcome priorities: A multi-perspective concept mapping study.

Alolayan W, Rieger J, Yoon M PLoS One. 2023; 18(11):e0294712.

PMID: 38033014 PMC: 10688684. DOI: 10.1371/journal.pone.0294712.

Neoadjuvant use of oncolytic herpes virus G47Δ prevents local recurrence after insufficient resection in tongue cancer models.

Inoue K, Ito H, Iwai M, Tanaka M, Mori Y, Todo T Mol Ther Oncolytics. 2023; 30:72-85.

PMID: 37583387 PMC: 10423690. DOI: 10.1016/j.omto.2023.07.002.

The Influence of the Oral Microbiome on Oral Cancer: A Literature Review and a New Approach.

Smedra A, Berent J Biomolecules. 2023; 13(5).

PMID: 37238685 PMC: 10216794. DOI: 10.3390/biom13050815.

References

Panchal J, Potterton A, Scanlon E, McLean N . An objective assessment of speech and swallowing following free flap reconstruction for oral cavity cancers. Br J Plast Surg. 1996; 49(6):363-9. DOI: 10.1016/s0007-1226(96)90004-1. View

Dwivedi R, Chisholm E, Khan A, Harris N, Bhide S, St Rose S . An exploratory study of the influence of clinico-demographic variables on swallowing and swallowing-related quality of life in a cohort of oral and oropharyngeal cancer patients treated with primary surgery. Eur Arch Otorhinolaryngol. 2011; 269(4):1233-9. DOI: 10.1007/s00405-011-1756-y. View

Rinkel R, Verdonck-de Leeuw I, de Bree R, Aaronson N, Leemans C . Validity of patient-reported swallowing and speech outcomes in relation to objectively measured oral function among patients treated for oral or oropharyngeal cancer. Dysphagia. 2015; 30(2):196-204. DOI: 10.1007/s00455-014-9595-9. View

Campbell B, Marbella A, Layde P . Quality of life and recurrence concern in survivors of head and neck cancer. Laryngoscope. 2000; 110(6):895-906. DOI: 10.1097/00005537-200006000-00003. View

Borggreven P, Aaronson N, Verdonck-de Leeuw I, Muller M, Heiligers M, de Bree R . Quality of life after surgical treatment for oral and oropharyngeal cancer: a prospective longitudinal assessment of patients reconstructed by a microvascular flap. Oral Oncol. 2007; 43(10):1034-42. DOI: 10.1016/j.oraloncology.2006.11.017. View

Petruson K, Mercke C, Lundberg L, Silander E, Hammerlid E . Longitudinal evaluation of patients with cancer in the oral tongue, tonsils, or base of tongue--does interstitial radiation dose affect quality of life?. Brachytherapy. 2005; 4(4):271-7. DOI: 10.1016/j.brachy.2005.06.001. View

Rinkel R, Verdonck-de Leeuw I, Doornaert P, Buter J, de Bree R, Langendijk J . Prevalence of swallowing and speech problems in daily life after chemoradiation for head and neck cancer based on cut-off scores of the patient-reported outcome measures SWAL-QOL and SHI. Eur Arch Otorhinolaryngol. 2015; 273(7):1849-55. PMC: 4899484. DOI: 10.1007/s00405-015-3680-z. View

Urken M, Moscoso J, Lawson W, Biller H . A systematic approach to functional reconstruction of the oral cavity following partial and total glossectomy. Arch Otolaryngol Head Neck Surg. 1994; 120(6):589-601. DOI: 10.1001/archotol.1994.01880300007002. View

Yang C, Roh J, Choi K, Kim M, Choi S, Nam S . Pretreatment Dysphagia Inventory and videofluorographic swallowing study as prognostic indicators of early survival outcomes in head and neck cancer. Cancer. 2015; 121(10):1588-98. DOI: 10.1002/cncr.29245. View

10.

Hartl D, Dauchy S, Escande C, Bretagne E, Janot F, Kolb F . Quality of life after free-flap tongue reconstruction. J Laryngol Otol. 2008; 123(5):550-4. DOI: 10.1017/S0022215108003629. View

11.

Shin Y, Koh Y, Kim S, Jeong J, Ahn S, Hong H . Radiotherapy deteriorates postoperative functional outcome after partial glossectomy with free flap reconstruction. J Oral Maxillofac Surg. 2011; 70(1):216-20. DOI: 10.1016/j.joms.2011.04.014. View

12.

Crombie A, Farah C, Batstone M . Health-related quality of life of patients treated with primary chemoradiotherapy for oral cavity squamous cell carcinoma: a comparison with surgery. Br J Oral Maxillofac Surg. 2013; 52(2):111-7. DOI: 10.1016/j.bjoms.2013.09.014. View

13.

Shi Q, Pavey E, Carter R . Bonferroni-based correction factor for multiple, correlated endpoints. Pharm Stat. 2012; 11(4):300-9. DOI: 10.1002/pst.1514. View

14.

Bjordal K, Hammerlid E, Ahlner-Elmqvist M, de Graeff A, Boysen M, Evensen J . Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. J Clin Oncol. 1999; 17(3):1008-19. DOI: 10.1200/JCO.1999.17.3.1008. View

15.

Thomas L, Moore E, Olsen K, Kasperbauer J . Long-term quality of life in young adults treated for oral cavity squamous cell cancer. Ann Otol Rhinol Laryngol. 2012; 121(6):395-401. DOI: 10.1177/000348941212100606. View

16.

Archontaki M, Athanasiou A, Stavrianos S, Korkolis D, Faratzis G, Papadopoulou F . Functional results of speech and swallowing after oral microvascular free flap reconstruction. Eur Arch Otorhinolaryngol. 2010; 267(11):1771-7. DOI: 10.1007/s00405-010-1275-2. View

17.

Bjordal K, de Graeff A, Fayers P, Hammerlid E, van Pottelsberghe C, Curran D . A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck patients. EORTC Quality of Life Group. Eur J Cancer. 2000; 36(14):1796-807. DOI: 10.1016/s0959-8049(00)00186-6. View

18.

Hutcheson K, Barrow M, Lisec A, Barringer D, Gries K, Lewin J . What is a clinically relevant difference in MDADI scores between groups of head and neck cancer patients?. Laryngoscope. 2015; 126(5):1108-13. PMC: 4842113. DOI: 10.1002/lary.25778. View

19.

Nordgren M, Hammerlid E, Bjordal K, Ahlner-Elmqvist M, Boysen M, Jannert M . Quality of life in oral carcinoma: a 5-year prospective study. Head Neck. 2007; 30(4):461-70. DOI: 10.1002/hed.20735. View

20.

Dwivedi R, St Rose S, Roe J, Chisholm E, Elmiyeh B, Nutting C . First report on the reliability and validity of speech handicap index in native English-speaking patients with head and neck cancer. Head Neck. 2010; 33(3):341-8. DOI: 10.1002/hed.21450. View