title: Long-term functional outcomes and quality of life after oncologic surgery and microvascular reconstruction in patients with oral or oropharyngeal cancer.
abstract: CONCLUSIONS
  Surgery for oral or oropharyngeal cancer with free-flap reconstruction is associated with moderate but persistent functional and quality of life (QoL) problems. Patient age, tumor stage, tumor site, and radiotherapy were the main predictors of functional outcome.
  
  
  OBJECTIVE
  To evaluate long-term functional outcomes and QoL, and to determine their predictive factors in patients with oral or oropharyngeal cancer after oncologic surgery and free-flap reconstruction.
  
  
  METHODS
  Patients who underwent surgery with free-flap reconstruction for oral or oropharyngeal cancer between 2000 and 2009 who were alive at least 1 year after therapy were included in this study. Patients completed the Voice Handicap Index (VHI-10) questionnaire and the European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaires QLQ-C30 and H&N35. Swallowing was evaluated using the Dysphagia Outcome and Severity Scale (DOSS) and by flexible fiberoptic laryngoscopy.
  
  
  RESULTS
  Sixty-four patients were included in the study. VHI-10 mean score was 11.2 ± 9 and its predictive factors were T stage (p = 0.005) and tumor involvement of the tongue base (p = 0.01). The mean DOSS score was 4 ± 0.8. Age (p = 0.008), gender (p = 0.04), and radiotherapy (p = 0.001) were the main predictive factors of the DOSS score.
authors.affiliation: Institut Universitaire de la Face et du Cou , Nice.
authors.forename: Cédric S
authors.initials: CS
authors.lastname: Pierre
authors.forename: Olivier
authors.initials: O
authors.lastname: Dassonville
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chamorey
authors.forename: Gilles
authors.initials: G
authors.lastname: Poissonnet
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Riss
authors.forename: Marc
authors.initials: M
authors.lastname: Ettaiche
authors.forename: Frédéric
authors.initials: F
authors.lastname: Peyrade
authors.forename: Karen
authors.initials: K
authors.lastname: Benezery
authors.forename: Marie-Eve
authors.initials: ME
authors.lastname: Chand
authors.forename: Axel
authors.initials: A
authors.lastname: Leyssalle
authors.forename: Anne
authors.initials: A
authors.lastname: Sudaka
authors.forename: Juliette
authors.initials: J
authors.lastname: Haudebourg
authors.forename: José
authors.initials: J
authors.lastname: Santini
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bozec
mesh_terms: D000222:Adaptation, Physiological; D000368:Aged; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D007825:Laryngectomy / Q000379:methods / Q000523:psychology; D016014:Linear Models; D008297:Male; D055806:Microvessels / Q000601:surgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D015999:Multivariate Analysis; D019647:Oral Surgical Procedures / Q000379:methods / Q000523:psychology; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D000077195:Squamous Cell Carcinoma of Head and Neck; D013524:Surgical Flaps / Q000098:blood supply*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014833:Voice Quality
keywords: Swallowing; cancer; free flap; oral cavity; oropharynx; speech; surgery