Evaluation of quality of life in patients with oral cancer after mandibular resection

Abstract

This cross-sectional study aimed to assess and compare quality of life in patients with advanced oral cavity tumors after mandibular resection in 3 groups (no reconstruction, reconstruction with plate, and reconstruction with flap) at the Cancer Institute, affiliated to Tehran University of Medical Sciences. Quality of life was measured using the European Organization for Research and Treatment of Cancer core quality of life questionnaire and European Organization for Research and Treatment of Cancer head and neck cancer-specific quality of life questionnaire-35 items. The comparison was tested using Kurskal–Wallis analysis. All 120 patients were entered into the study. The mean age of patients was 48.5 (standard deviation = 18.1) years. Patients presented with advanced stage of the disease and underwent mandibular resection with no reconstruction (n = 40), reconstruction with plate (n = 41), and reconstruction with flap (n = 39). The findings showed that in general, there were no statistically significant differences in quality of life among 3 groups except for speech problem (P = .4), dry mouth (P = .03), and feeling ill (P = .04). Although there were no significant differences in quality of life among patients in 3 groups, overall patients who received reconstruction with flap reported better functioning and fewer symptoms. Those who did not receive any reconstruction reported the worse conditions.

Only a Plate? Nine-Year Follow-Up After Partial Mandibulectomy and Reconstruction With Titanium Plate

“…In turn, this can cause dysfunction with speech, chewing and swallowing. 6 Mandibular reconstruction should provide restoration of these dysfunctions, leading to optimal functional and aesthetical results that can post-operatively improve the patient's quality of life. 15,16 This can be provided by restoring the continuity of the mandibular arch, establishing arch form, width, alveolar height, maintaining and restoring internal/external soft tissue coverage, eliminate occurrences of fistulas and provide a basis for future dental rehabilitation.…”

“…50,51 All things considered, patients have not reported any significant differences in quality of life when comparing those who were treated with reconstruction plates and those treated with flaps. 6,52 Although the nature of complications naturally differs between the 2 groups, the frequency of complications appears to be equal. 32,53…”

“…4,5 Since the 1980s, alternative methods such as the use of alloplastic devices, rigid mandibular reconstruction plates, with simultaneous or subsequent bone grafting for restoring mandibular continuity following a partial or total mandibulectomy, has been developed. 3,[6][7][8][9] The use of alloplastic devices in combination with proper soft tissue repair has enabled acceptable restoration of the mandibular tumor defects. Because of the necessity for secondary bone reconstruction to be able to restore masticatory and dental function, these repairs were limited.…”

Health-Related Quality of Life in Oral Cancer Patients: Scoping Review and Critical Appraisal of Investigated Determinants

“…Performed mandibular resection was overtly reported in 15 articles-data stratification was properly performed in three [23,36,46]; incomplete/inadequate stratification was performed in one (which compared no mandibular resection group to patients undergoing mandibular resection grouping together with those who received marginal and segmental resections) [24]; six studies clearly stated that none of the included cases underwent mandibular resection [28,31,38,39,45,49]; and in three studies, the investigated population homogeneously underwent segmental mandibular resection [29,40,48].…”

Locally Advanced Oral Cavity Cancers: What Is The Optimal Care?

“…The extent of the surgical procedure and the type of reconstruction may have significant influence on the patients' QoL. 52,53 On the other hand, using IMRT was proven to significantly improve QoL in patients who underwent RT treatment compared to other techniques in a meta-analyses by Ge et al 54 Unfortunately, a large proportion of locally advanced oral cavity squamous cell carcinomas do not qualify for curative treatment for many reasons. Therefore, the goal of treating these patients should be palliative in nature.…”