Skip to main content
Top
Published in: Oral and Maxillofacial Surgery 1/2020

Open Access 01-03-2020 | Original Article

Long-term quality of life after surgery of head and neck cancer with microvascular reconstruction: a prospective study with 4.9-years follow-up

Authors: Satu Kainulainen, A. M. Koivusalo, R. P. Roine, T. Wilkman, H. Sintonen, J. Törnwall, H. Thorén, P. Lassus

Published in: Oral and Maxillofacial Surgery | Issue 1/2020

Login to get access

Abstract

Purpose

The aim of this study was to evaluate the long-term health-related quality of life (HRQoL) of head and neck cancer patients with microvascular surgery. Surgical treatment causes great changes in patient HRQoL. Studies focusing on long-term HRQoL after microvascular reconstruction for head and neck cancer patients are scarce.

Methods

We conducted a prospective study of 93 patients with head and neck cancer and microvascular reconstruction in Helsinki University Hospital Finland. HRQoL was measured using the 15D instrument at baseline and after a mean 4.9-years follow up. Results were compared with those of an age-standardized general population.

Results

Of the 93 patients, 61 (66%) were alive after follow-up; of these, 42 (69%) answered the follow-up questionnaire. The median time between surgery and HRQoL assessment was 4.9 years (range 3.7–7.8 years). The mean 15D score of all patients (n = 42) at the 4.9-years follow up was statistically significantly (p = 0.010) and clinically importantly lower than at baseline. The dimensions of “speech” and “usual activities” were significantly impaired at the end of follow up. There was a significant difference at the 4.9-years follow-up in the mean 15D score between patients and the general population (p = 0.014). After follow up, patients were significantly (p < 0.05) worse off on the dimensions of “speech,” “eating,” and “usual activities.”

Conclusions

Long-term HRQoL was significantly reduced in the whole patient cohort. Speech and usual activities were the most affected dimensions in head and neck cancer patients with microvascular reconstruction at the end of the 4.9-years follow up.
Literature
2.
go back to reference Terrell JE, Ronis DL, Fowler KE, Bradford CR, Chepeha DB, Prince ME, Teknos TN, Wolf GT, Duffy SA (2004) Clinical predictors of quality of life in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 130(4):401–408CrossRef Terrell JE, Ronis DL, Fowler KE, Bradford CR, Chepeha DB, Prince ME, Teknos TN, Wolf GT, Duffy SA (2004) Clinical predictors of quality of life in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 130(4):401–408CrossRef
3.
go back to reference Rogers SN, Ahad SA, Murphy AP (2007) A structured review and theme analysis of papers published on 'quality of life' in head and neck cancer: 2000-2005. Oral Oncol 43(9):843–868CrossRef Rogers SN, Ahad SA, Murphy AP (2007) A structured review and theme analysis of papers published on 'quality of life' in head and neck cancer: 2000-2005. Oral Oncol 43(9):843–868CrossRef
4.
go back to reference Hassan SJ, Weymuller EA Jr (1993) Assessment of quality of life in head and neck cancer patients. Head Neck 15(6):485–496CrossRef Hassan SJ, Weymuller EA Jr (1993) Assessment of quality of life in head and neck cancer patients. Head Neck 15(6):485–496CrossRef
5.
go back to reference Murphy BA, Ridner S, Wells N, Dietrich M (2007) Quality of life research in head and neck cancer: a review of the current state of the science. Crit Rev Oncol Hematol 62(3):251–267CrossRef Murphy BA, Ridner S, Wells N, Dietrich M (2007) Quality of life research in head and neck cancer: a review of the current state of the science. Crit Rev Oncol Hematol 62(3):251–267CrossRef
6.
go back to reference Singer S, Araujo C, Arraras JI, Baumann I, Boehm A, Brokstad Herlofson B et al (2015) Measuring quality of life in patients with head and neck cancer: update of the EORTC QLQ-H&N Module, phase III. Head Neck 37(9):1358–1367CrossRef Singer S, Araujo C, Arraras JI, Baumann I, Boehm A, Brokstad Herlofson B et al (2015) Measuring quality of life in patients with head and neck cancer: update of the EORTC QLQ-H&N Module, phase III. Head Neck 37(9):1358–1367CrossRef
7.
go back to reference Hammerlid E, Taft C (2001) Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms. Br J Cancer 84(2):149–156CrossRef Hammerlid E, Taft C (2001) Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms. Br J Cancer 84(2):149–156CrossRef
8.
go back to reference Pierre CSI, Dassonville O, Chamorey E, Poissonnet G, Ettaiche M, Santini J, Peyrade F, Benezery K, Sudaka A, Bozec A (2014) Long-term quality of life and its predictive factors after oncologic surgery and microvascular reconstruction in patients with oral or oropharyngeal cancer. Eur Arch Otorhinolaryngol 271(4):801–807. https://doi.org/10.1007/s00405-013-2592-z CrossRef Pierre CSI, Dassonville O, Chamorey E, Poissonnet G, Ettaiche M, Santini J, Peyrade F, Benezery K, Sudaka A, Bozec A (2014) Long-term quality of life and its predictive factors after oncologic surgery and microvascular reconstruction in patients with oral or oropharyngeal cancer. Eur Arch Otorhinolaryngol 271(4):801–807. https://​doi.​org/​10.​1007/​s00405-013-2592-z CrossRef
9.
go back to reference Rana M, Kanatas A, Herzberg PY, Khoschdell M, Kokemueller H, Gellrich NC, Rana M (2015) Prospective study of the influence of psychological and medical factors on quality of life and severity of symptoms among patients with oral squamous cell carcinoma. Br J Oral Maxillofac Surg 53(4):364–370CrossRef Rana M, Kanatas A, Herzberg PY, Khoschdell M, Kokemueller H, Gellrich NC, Rana M (2015) Prospective study of the influence of psychological and medical factors on quality of life and severity of symptoms among patients with oral squamous cell carcinoma. Br J Oral Maxillofac Surg 53(4):364–370CrossRef
10.
go back to reference Kainulainen S, Tornwall J, Koivusalo AM, Suominen AL, Lassus P (2017) Dexamethasone in head and neck cancer patients with microvascular reconstruction: no benefit, more complications. Oral Oncol 65:45–50CrossRef Kainulainen S, Tornwall J, Koivusalo AM, Suominen AL, Lassus P (2017) Dexamethasone in head and neck cancer patients with microvascular reconstruction: no benefit, more complications. Oral Oncol 65:45–50CrossRef
11.
go back to reference Farkkila N, Torvinen S, Roine RP, Sintonen H, Hanninen J, Taari K et al (2014) Health-related quality of life among breast, prostate, and colorectal cancer patients with end-stage disease. Qual Life Res Int J Qual Life Asp Treat Care Rehab 23(4):1387–1394 Farkkila N, Torvinen S, Roine RP, Sintonen H, Hanninen J, Taari K et al (2014) Health-related quality of life among breast, prostate, and colorectal cancer patients with end-stage disease. Qual Life Res Int J Qual Life Asp Treat Care Rehab 23(4):1387–1394
14.
go back to reference Richardson J, Iezzi A, Khan MA, Chen G, Maxwell A (2016) Measuring the sensitivity and construct validity of 6 utility instruments in 7 disease areas. Med Decis Making 36(2):147–159CrossRef Richardson J, Iezzi A, Khan MA, Chen G, Maxwell A (2016) Measuring the sensitivity and construct validity of 6 utility instruments in 7 disease areas. Med Decis Making 36(2):147–159CrossRef
15.
go back to reference Sintonen H (2001) The 15D instrument of health-related quality of life: properties and applications. Ann Med 33(5):328–336CrossRef Sintonen H (2001) The 15D instrument of health-related quality of life: properties and applications. Ann Med 33(5):328–336CrossRef
16.
go back to reference Alanne S, Roine RP, Rasanen P, Vainiola T, Sintonen H (2015) Estimating the minimum important change in the 15D scores. Qual Life Res Int J Qual Life Asp Treat Care Rehab 24(3):599–606 Alanne S, Roine RP, Rasanen P, Vainiola T, Sintonen H (2015) Estimating the minimum important change in the 15D scores. Qual Life Res Int J Qual Life Asp Treat Care Rehab 24(3):599–606
17.
go back to reference Hawthorne G, Richardson J, Day NA (2001) A comparison of the assessment of quality of life (AQoL) with four other generic utility instruments. Ann Med 33(5):358–370CrossRef Hawthorne G, Richardson J, Day NA (2001) A comparison of the assessment of quality of life (AQoL) with four other generic utility instruments. Ann Med 33(5):358–370CrossRef
18.
go back to reference Stavem K (1999) Reliability, validity and responsiveness of two multiattribute utility measures in patients with chronic obstructive pulmonary disease. Qual Life Res Int J Qual Life Asp Treat Care Rehab 8(1–2):45–54 Stavem K (1999) Reliability, validity and responsiveness of two multiattribute utility measures in patients with chronic obstructive pulmonary disease. Qual Life Res Int J Qual Life Asp Treat Care Rehab 8(1–2):45–54
19.
go back to reference Vainiola T, Pettila V, Roine RP, Rasanen P, Rissanen AM, Sintonen H (2010) Comparison of two utility instruments, the EQ-5D and the 15D, in the critical care setting. Intensive Care Med 36(12):2090–2093CrossRef Vainiola T, Pettila V, Roine RP, Rasanen P, Rissanen AM, Sintonen H (2010) Comparison of two utility instruments, the EQ-5D and the 15D, in the critical care setting. Intensive Care Med 36(12):2090–2093CrossRef
21.
go back to reference Durmus K, Patwa HS, Gokozan HN, Kucur C, Teknos TN, Agrawal A, Old MO, Ozer E (2014) Functional and quality-of-life outcomes of transoral robotic surgery for carcinoma of unknown primary. Laryngoscope 124(9):2089–2095CrossRef Durmus K, Patwa HS, Gokozan HN, Kucur C, Teknos TN, Agrawal A, Old MO, Ozer E (2014) Functional and quality-of-life outcomes of transoral robotic surgery for carcinoma of unknown primary. Laryngoscope 124(9):2089–2095CrossRef
22.
go back to reference Chen AM, Daly ME, Farwell DG, Vazquez E, Courquin J, Lau DH, Purdy JA (2014) Quality of life among long-term survivors of head and neck cancer treated by intensity-modulated radiotherapy. JAMA Otolaryngology Head & Neck Surg 140(2):129–133CrossRef Chen AM, Daly ME, Farwell DG, Vazquez E, Courquin J, Lau DH, Purdy JA (2014) Quality of life among long-term survivors of head and neck cancer treated by intensity-modulated radiotherapy. JAMA Otolaryngology Head & Neck Surg 140(2):129–133CrossRef
23.
go back to reference Bozec A, Demez P, Gal J, Chamorey E, Louis MY, Blanchard D, de Raucourt D, Merol JC, Brenet E, Dassonville O, Poissonnet G, Santini J, Peyrade F, Benezery K, Lesnik M, Berta E, Ransy P, Babin E (2018) Long-term quality of life and psycho-social outcomes after oropharyngeal cancer surgery and radial forearm free-flap reconstruction: a GETTEC prospective multicentric study. Surg Oncol 27(1):23–30CrossRef Bozec A, Demez P, Gal J, Chamorey E, Louis MY, Blanchard D, de Raucourt D, Merol JC, Brenet E, Dassonville O, Poissonnet G, Santini J, Peyrade F, Benezery K, Lesnik M, Berta E, Ransy P, Babin E (2018) Long-term quality of life and psycho-social outcomes after oropharyngeal cancer surgery and radial forearm free-flap reconstruction: a GETTEC prospective multicentric study. Surg Oncol 27(1):23–30CrossRef
24.
go back to reference Holloway RL, Hellewell JL, Marbella AM, Layde PM, Myers KB, Campbell BH (2005) Psychosocial effects in long-term head and neck cancer survivors. Head Neck 27(4):281–288CrossRef Holloway RL, Hellewell JL, Marbella AM, Layde PM, Myers KB, Campbell BH (2005) Psychosocial effects in long-term head and neck cancer survivors. Head Neck 27(4):281–288CrossRef
25.
go back to reference Zelefsky MJ, Gaynor J, Kraus D, Strong EW, Shah JP, Harrison LB (1996) Long-term subjective functional outcome of surgery plus postoperative radiotheraphy for advanced stage oral cavity and oropharyngeal carcinoma. Am J Surg 171(2):258–261; discussion 62CrossRef Zelefsky MJ, Gaynor J, Kraus D, Strong EW, Shah JP, Harrison LB (1996) Long-term subjective functional outcome of surgery plus postoperative radiotheraphy for advanced stage oral cavity and oropharyngeal carcinoma. Am J Surg 171(2):258–261; discussion 62CrossRef
26.
go back to reference Bozec A, Poissonnet G, Chamorey E, Casanova C, Vallicioni J, Demard F, Mahdyoun P, Peyrade F, Follana P, Bensadoun RJ, Benezery K, Thariat J, Marcy PY, Sudaka A, Dassonville O (2008) Free-flap head and neck reconstruction and quality of life: a 2-year prospective study. Laryngoscope 118(5):874–880CrossRef Bozec A, Poissonnet G, Chamorey E, Casanova C, Vallicioni J, Demard F, Mahdyoun P, Peyrade F, Follana P, Bensadoun RJ, Benezery K, Thariat J, Marcy PY, Sudaka A, Dassonville O (2008) Free-flap head and neck reconstruction and quality of life: a 2-year prospective study. Laryngoscope 118(5):874–880CrossRef
27.
go back to reference Infante-Cossio P, Torres-Carranza E, Cayuela A, Hens-Aumente E, Pastor-Gaitan P, Gutierrez-Perez JL (2009) Impact of treatment on quality of life for oral and oropharyngeal carcinoma. Int J Oral Maxillofac Surg 38(10):1052–1058CrossRef Infante-Cossio P, Torres-Carranza E, Cayuela A, Hens-Aumente E, Pastor-Gaitan P, Gutierrez-Perez JL (2009) Impact of treatment on quality of life for oral and oropharyngeal carcinoma. Int J Oral Maxillofac Surg 38(10):1052–1058CrossRef
28.
go back to reference Langendijk JA, Doornaert P, Verdonck-de Leeuw IM, Leemans CR, Aaronson NK, Slotman BJ (2008) Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer treated with radiotherapy. J Clin Oncol 26(22):3770–3776CrossRef Langendijk JA, Doornaert P, Verdonck-de Leeuw IM, Leemans CR, Aaronson NK, Slotman BJ (2008) Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer treated with radiotherapy. J Clin Oncol 26(22):3770–3776CrossRef
Metadata
Title
Long-term quality of life after surgery of head and neck cancer with microvascular reconstruction: a prospective study with 4.9-years follow-up
Authors
Satu Kainulainen
A. M. Koivusalo
R. P. Roine
T. Wilkman
H. Sintonen
J. Törnwall
H. Thorén
P. Lassus
Publication date
01-03-2020
Publisher
Springer Berlin Heidelberg
Published in
Oral and Maxillofacial Surgery / Issue 1/2020
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-019-00806-w

Other articles of this Issue 1/2020

Oral and Maxillofacial Surgery 1/2020 Go to the issue