RESUMEN
BACKGROUND: The tongue has an indispensable role in communication, swallowing and breathing. Tongue cancer treatment involves direct resection of the tumor and surrounding tissue, which can limit many essential functions of the tongue. There are few patient-reported quality of life studies involving tongue cancer exclusively. There is also a lack of data on the outcomes of quality of life regarding different reconstructive methods, adjuvant non-surgical therapies and other predicting factors. Our objective is to assess the quality of life, functional status, and predicting factors in patients with tongue cancer up to one year after surgical resection. MATERIAL AND METHODS: Thirty-six patients with tongue cancer were prospectively identified between October of 2017 and January 2021. Patients were examined before and one, three, six and twelve months after surgical resection with the validated University of Washington Quality of Life questionnaire (UW-QOL). Data collection included patient age, sex, TNM staging, size of resection, neck dissection, tracheostomy, reconstructive method and adjuvant therapies. Outcome scores were compared using the Friedman test. Multiple linear regression analysis was used to identify the predictors of quality of life and functional status. RESULTS: The use of UWQOL scores as dependent variables revealed the following predicting factors: age, tobacco use, radiotherapy, chemotherapy, reconstruction method and neck dissection. CONCLUSIONS: The most relevant findings in our study are that flap reconstruction becomes increasingly necessary when a glossectomy resection is over 45 mm, in order to maintain tongue function. We established that the reconstructive flap type does not influence quality of life in the long term. Also, we have found that cervical sentinel node biopsy provides better quality of life over neck dissection in the first 3 months after surgery.
Asunto(s)
Neoplasias de la Lengua , Humanos , Neoplasias de la Lengua/cirugía , Calidad de Vida , Estudios Prospectivos , Lengua , Terapia CombinadaRESUMEN
El cáncer oral es un problema de salud con el que nos enfrentamos todos los días en nuestras consultas. Los dentistas formamos la primera línea de defensa ante una patología que no ha presentado una mejora de los índices de mortalidad y morbilidad en las últimas décadas. La principal arma con la que contamos es la del diagnóstico precoz de la enfermedad, y esto es mucho más complicado de lo que parece. Para ayudar a los dentistas en la visualización de lesiones de precáncer o cáncer temprano han aparecido algunas técnicas o dispositivos de screening de cáncer oral basadas en la interacción de los tejidos orales con la luz. La técnica más extendida y estudiada es la basada en la quimioluminiscencia, intentaremos poner en claro algunos aspectos analizando los estudios que hay en la literatura actual (AU)
Oral cancer is a health problem with which we face every day in our consultations. Dentists form the first line of defense against a disease that has not produced an improvement in mortality and morbidity in recent decades. The main weapon with which we have is the early diagnosis of the disease, and this is much more complicated than it seems. To assist dentists in the visualization of pre-cancer lesions or early cancer have appeared some techniques and devices for oral cancer screening based on interaction of the oral tissues withlight. The most widely used and studied technique is based on the chemiluminescence. Above it has been much talk and try to clarify some aspects of the studies that are analyzing the current literature (AU)
Asunto(s)
Humanos , Lesiones Precancerosas/diagnóstico , Mediciones Luminiscentes , Neoplasias de la Boca/diagnóstico , Factores de Riesgo , Tamizaje MasivoRESUMEN
La leucoplasia es definida actualmente en base a un concepto esencialmente clínico. En este sentido, se propone un diagnóstico provisional de leucoplasia basado en criterios clínicos y un diagnóstico definitivo para el que se requiere la eliminación de los factores etiológicos y, ante lesiones persistentes, el examen histopatológico. La consideración de la leucoplasia como lesión precancerosa proviene esencialmente de los estudios de seguimiento en los que se constata su transformación maligna. Pese a que el diagnóstico de displasia es esencialmente subjetivo y a la existencia de algún trabajo reciente que no encuentra relación entre ésta y la evolución posterior de las leucoplasias, la presencia de displasia epitelial en el examen histológico se considera actualmente como el indicador más importante de una mayor probabilidad de transformación maligna de la leucoplasia. Entre otros factores relacionados con un peor pronóstico se consideran el que se trate de una leucoplasia idiopática, las formas clínicas no homogéneas, la localización en cara ventrolateral de la lengua y suelo de boca y un tamaño mayor de 1 centímetro (AU)
The current definition of leukoplakia is based on an essentially clinical concept. Therefore, both a provisional diagnosis of leukoplakia based on clinical criteria and a definite diagnosis for which etiological factors need to be eliminated and, should there be persistent lesions, a histological examination is required, are accepted. Follow up studies in which a malignant transformation has been observed have resulted in leukoplakia being considered as a precancerous disorder. Despite the fact that the diagnosis of dysplasia is subjective and certain recent studies have not found any association between this and the development of leukoplakia, the presence of epithelial dysplasia in the histological examination is currently considered to be the most important indicator of a higher possibility of malignant transformation of the leukoplakia. Among other factors that may indicate a worse prognosis are: if the leukoplakia is idiopathic, if clinical forms are non-homogenous, if it is located on the ventrolateral side of the tongue and the floor of the mouth, and if it is over 1 cm. (0.40 inches) in size (AU)
Asunto(s)
Leucoplasia Bucal/complicaciones , Leucoplasia Bucal/epidemiología , Leucoplasia Bucal/patología , Pronóstico , Odontodisplasia/complicaciones , Odontodisplasia/diagnóstico , Factores de Riesgo , Nicotiana/efectos adversos , Candida albicans/patogenicidad , Diagnóstico Diferencial , Leucoplasia Bucal/diagnóstico , Lengua/anatomía & histología , Lengua/patología , Erupciones Liquenoides/complicaciones , Colgajos Quirúrgicos , Antioxidantes/uso terapéuticoRESUMEN
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