ABSTRACT
PURPOSE: Health-related quality of life (HRQOL) has now become an important outcome measure in the assessment of patients treated for oral cancer. We summarize the influence of various factors in the treatment of oral cancer on HRQOL after surgery. METHODS: A review of the current literature was carried out. RESULTS: Site-specific assessment of HRQOL should be encouraged, rather than assessment of head and neck cancer as a whole. In general the long-term HRQOL of oral cancer patients seems good with HRQOL at 1 year being equivalent to long-term HRQOL. A number of different patient and treatment factors were identified that affect HRQOL. These include age, gender, site, stage, emotional status, smoking and alcohol, marital status and income, performance status, method of reconstruction, access, mandibular resection, neck dissection, percutaneous endoscopic gastrostomy, and post-operative radiotherapy. CONCLUSIONS: HRQOL should be considered as part of the overall process of care for oral cancer patients.
Subject(s)
Gastrostomy/psychology , Mouth Neoplasms/therapy , Neck Dissection/psychology , Plastic Surgery Procedures/psychology , Quality of Life , Age Factors , Head and Neck Neoplasms/psychology , Head and Neck Neoplasms/therapy , Humans , Mandible/surgery , Mouth Neoplasms/psychology , Sex Factors , Surveys and Questionnaires , Treatment OutcomeABSTRACT
PURPOSE: The outcome of management strategies for the treatment of oral cancer has always been in terms of disease-specific survival. Modern assessment of outcome now also includes assessment of quality of life (QOL). Little has been done previously in Australia to assess the QOL of patients treated primarily by surgery for oral cancer. MATERIALS AND METHODS: Twenty-two patients who had undergone primary surgical management for oral cancer underwent assessment of QOL using the European Organization for Research and Treatment of Cancer QOL questionnaire version 3 (EORTC QLQ-C30) and the University of Washington Head and Neck QOL questionnaire version 4 (UWQOL). Similar emotional domains were compared and factors affecting QOL were determined. RESULTS: Fifty-five percent of patients were male and 45% were female. The mean age was 61.8 years (range, 38 to 86 years) with a mean review time of 24.6 months (SD, 20.3 months) postoperatively. Good QOL scores were experienced by most patients. A new addition to the UWQOL version 4 was the mood and anxiety domains, and these correlated well with the emotional domains of the EORTC QLQ-C30 using Spearman rank correlations. Factors significantly affecting survival included age, overall stage, neck dissection, free flap, and postoperative radiotherapy using Mann-Whitney tests (P < .05). No significant difference in QOL was found in patients reviewed at either less than or greater than 1 year. CONCLUSIONS: This study confirms previous reports in the literature. It has provided us with the foundation for further investigation of QOL in patients who have been and who will be treated for oral cancer. It also gives us a new measure of outcome to compare against survival rates.
Subject(s)
Mouth Neoplasms/psychology , Mouth Neoplasms/surgery , Outcome Assessment, Health Care/methods , Quality of Life/psychology , Surveys and Questionnaires , Adult , Aged , Australia , Cross-Sectional Studies , Emotions , Female , Follow-Up Studies , Health Status Indicators , Humans , Male , Middle Aged , Pilot Projects , Statistics, NonparametricABSTRACT
Synchronous oral and gastric carcinoma in the western world is rare. We report a case of synchronous oral squamous cell carcinoma (SCC) and gastric adenocarcinoma which was found as an incidental finding during placement of a Percutaneous Endoscopic Gastrostomy (PEG) before resection of the oral tumour.
