title: Quality of life after free-flap reconstruction in patients with oral and pharyngeal cancer.
abstract: BACKGROUND
  Our aim was to investigate quality of life and outcome after microvascular free-flap reconstruction after oncologic surgery.
  
  
  METHODS
  Forty-four patients with a large carcinoma in the oral cavity, oral pharynx, or hypopharynx underwent free-flap surgery with or without radiotherapy. Patients completed the University of Washington Quality-of-Life Questionnaire preoperatively and four times during the 12 postoperative months. Survival rates and complications were analyzed.
  
  
  RESULTS
  Postoperative composite quality-of-life scores were significantly lower than before treatment with no significant overall improvement during the follow-up. The scores for disfigurement, chewing, speech, and shoulder function remained significantly below the preoperative level throughout the follow-up. Sociodemographic factors predicted quality of life. Heavy drinking and unemployment caused a 2.4-fold and a 4.4-fold increase in risk of death, respectively. The rates for overall survival, tumor recurrence, flap success, and surgical complications were consistent with previous literature.
  
  
  CONCLUSIONS
  Sociodemographic variables affect quality of life and patient survival in patients with oral cancer treated with microvascular free-flap reconstruction.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, P. O. Box 220, FIN-00029 HUS, Helsinki, Finland.
authors.forename: Mari
authors.initials: M
authors.lastname: Markkanen-Leppänen
authors.forename: Antti A
authors.initials: AA
authors.lastname: Mäkitie
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Haapanen
authors.forename: Erkki
authors.initials: E
authors.lastname: Suominen
authors.forename: Sirpa
authors.initials: S
authors.lastname: Asko-Seljavaara
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D015897:Comorbidity; D004522:Educational Status; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D010610:Pharyngeal Neoplasms / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D011183:Postoperative Complications; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D014478:Unemployment