RESUMO
OBJECTIVES: This prospective study was designed to evaluate quality of life (QOL) after free-flap head and neck reconstruction. STUDY DESIGN: Prospective study. METHODS: : Between January 2004 and December 2005, a total of 95 patients underwent microvascular reconstruction of the head and neck at our Institution (Centre Antoine-Lacassagne, Nice, France) and were initially included in this study. The European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and the EORTC Head and Neck Cancer Quality of Life Questionnaire were completed before surgery, and at 6 and 12 months thereafter. Sixty-five patients completed the questionnaires on at least two of the assessment dates. Predictive factors of Quality of Life (QOL) scores at 6 months were researched among the following: age, sex, comorbidity, radiotherapy, tumor recurrence, tumor stage, and type of surgery. RESULTS: Global QOL remained stable over time. Physical, social, and role functioning deteriorated significantly after treatment. Pain decreased markedly. Social eating, senses, and speech difficulties increased significantly at 6 months, but stabilized between 6 and 12 months. Problems concerning mouth opening and social contact augmented progressively until the 12th postoperative month. Sex, type of surgery, and radiotherapy were the main factors influencing QOL 6 months after treatment. CONCLUSIONS: Despite some functional impairments, global QOL was preserved after major head and neck ablative surgery and microvascular free-flap reconstruction.
Assuntos
Carcinoma de Células Escamosas/psicologia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Laríngeas/psicologia , Neoplasias Laríngeas/cirurgia , Neoplasias Orofaríngeas/psicologia , Neoplasias Orofaríngeas/cirurgia , Neoplasias dos Seios Paranasais/psicologia , Neoplasias dos Seios Paranasais/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Qualidade de Vida/psicologia , Retalhos Cirúrgicos , Adulto , Idoso , Carcinoma de Células Escamosas/radioterapia , Terapia Combinada , Progressão da Doença , Feminino , Humanos , Neoplasias Laríngeas/radioterapia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/radioterapia , Neoplasias dos Seios Paranasais/radioterapia , Estudos Prospectivos , Inteligibilidade da Fala , Inquéritos e Questionários , Fatores de TempoRESUMO
OBJECTIVE: To evaluate quality of life (QOL) after radial forearm free flap (RFFF) reconstruction of the oral cavity and oropharynx in head and neck cancer patients. DESIGN: Prospective study. SETTING: Academic, tertiary referral centre. METHODS: Between January 2004 and May 2005, 47 patients underwent immediate RFFF reconstruction of the oral cavity and oropharynx following ablative surgery for a previously untreated head and neck cancer and were initially included in this study. The European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and the EORTC Head and Neck Cancer Quality of Life Questionnaire were completed before surgery and at 6 and 12 months thereafter. MAIN OUTCOME MEASURES: QOL scores obtained at the three assessment dates. Predictive factors of QOL scores at 6 months researched among the following: age, gender, comorbidity, radiotherapy, tumour stage, and tumour site. RESULTS: Global QOL remained stable over time. Social and role functioning scores deteriorated significantly after treatment. Social eating and speech difficulties, trismus, and salivary problems increased significantly in the postoperative period and were among the main complaints of our patients. CONCLUSIONS: Despite some functional impairment, global QOL was preserved after RFFF reconstruction following extensive ablative surgery in patients with oral and oropharyngeal cancer.