Health-related quality of life following reconstruction for common head and neck surgical defects Journal Article

Authors: Cohen, W. A.; Albornoz, C. R.; Cordeiro, P. G.; Cracchiolo, J.; Encarnacion, E.; Lee, M.; Cavalli, M.; Patel, S.; Pusic, A. L.; Matros, E.
Article Title: Health-related quality of life following reconstruction for common head and neck surgical defects
Abstract: Background: Improved understanding and management of health-related quality of life represents one of the greatest unmet needs for patients with head and neck malignancies. The purpose of this study was to prospectively measure health-related quality of life associated with different anatomical (head and neck) surgical resections. Methods: A prospective analysis of health-related quality of life was performed in patients undergoing surgical resection with flap reconstruction for stage II or III head and neck malignancies. Patients completed the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire-30 and the European Organization for Research and Treatment of Cancer Head and Neck Cancer Module-35 preoperatively, and at set postoperative time points. Scores were compared with a paired t test. Results: Seventy-five patients were analyzed. The proportion of the cohort not alive at 2 years was 53 percent. Physical, role, and social functioning scores at 3 months were significantly lower than preoperative values (p < 0.05). At 12 months postoperatively, none of the function or global quality-of-life scores differed from preoperative levels, whereas five of the symptom scales remained below baseline. At 1 year postoperatively, maxillectomy, partial glossectomy, and oral lining defects had better function and fewer symptoms than mandibulectomy, laryngectomy, and total glossectomy. From 6 to 12 months postoperatively, partial glossectomy and oral lining defects had greater global quality of life than laryngectomies (p < 0.05). Conclusions: Postoperative health-related quality of life is associated with the anatomical location of the head and neck surgical resection. Preoperative teaching should be targeted for common ablative defects, with postoperative expectations adjusted appropriately. Because surgery negatively impacts health-related quality of life in the immediate postoperative period, the limited survivorship should be reviewed with patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. © 2016 by the American Society of Plastic Surgeons.
Journal Title: Plastic and Reconstructive Surgery
Volume: 138
Issue: 6
ISSN: 0032-1052
Publisher: Lippincott Williams & Wilkins  
Date Published: 2016-12-01
Start Page: 1312
End Page: 1320
Language: English
DOI: 10.1097/prs.0000000000002766
PROVIDER: scopus
PUBMED: 27879602
PMCID: PMC5559272
Notes: Article -- Export Date: 3 January 2017 -- Source: Scopus
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MSK Authors
  1. Andrea Pusic
    281 Pusic
  2. Snehal G Patel
    292 Patel
  3. Peter G Cordeiro
    239 Cordeiro
  4. Evan Matros
    73 Matros
  5. Wess   Cohen
    8 Cohen
  6. Meghan Elizabeth Lee
    1 Lee