Survival, Function, and Quality of Life After Total Glossectomy

Abstract

Advanced tongue cancer is associated with poor survival despite aggressive therapy. In an attempt at cure, many patients undergo total glossectomy, which significantly affects function and quality of life (QOL). This study was designed to determine the survival rate and QOL of patients who had undergone total glossectomy. A total of 54 patients underwent total glossectomy, with or without total laryngectomy, for advanced tongue cancer from 1970 to 1996. Patient outcomes were assessed for the following: 1. disease-free survival, 2. function, utilizing the Performance Status Scale (PSS), and 3. QOL, using two general cancer questionnaires (FACT-G and EORTC QLQ-C30) and a series of questions specific for head and neck cancer patients. Corrected actuarial survival was 51% and 41% at 3 and 5 years, respectively. Functional assessment using the PSS demonstrated significant deficits in speech and deglutition. QOL questionnaires revealed problems with eating, speaking, socializing, and shoulder function. However, the overall responses demonstrated that these patients have adjusted to their deficits and have a good QOL. It was concluded that total glossectomy, with or without total laryngectomy, can result in meaningful survival and an adequate QOL can be achieved in selected patients.

Comparison of Psychosocial Outcomes in Head and Neck Cancer Patients Receiving a Coping Strategies Intervention and Control Subjects Receiving No Intervention

“…As an example, despite sorne cancer patients reporting significant functional impairment, surprisingly high levels of quality of life has been observed (Ruhl et al, 1997). A cohort study with 153 head ~nd neck patients found that high levels of depressive symptons, low performance status, and combined modality treatment were significant predictors of poor functioning and psychological morbidity after treatment (De Graeff et al, 2000b).…”

“…Furtherrnore, Allison et al (1999) suggested that the dental status may play an important role in the quality of life of head and neck cancer patients (Alli son et al, 1999). Finally, support from the farnily, friends (Ruhl et al, 1997) and the farnily doctor (Mathieson et al, 1996), and the patients' perception of the disease (i.e. state of rnind and optrnism) (Allison et al, 2000;Allison et al, 2003;Greer et al, 1992) may favorably influence the disease recovery and be of great value for the patients' quality of life.…”

The surgical management and speech and swallowing rehabilitation of patients with advanced tongue cancer in South Africa

“…This average implies that only 20% of total glossectomy patients survive for a period of five years. Ruhl et al (1997Ruhl et al ( :1321 reported survival of 51% and 41% at three and five years respectively for 54 total glossectomy patients.…”

“…Surgical resection, followed by immediate reconstruction, neck dissection (unilateral/bilateral) and post-operative radiation therapy is considered the favoured combination of treatment modalities for patients with advanced tongue disease (Salibian, Allison, Rappaport, Krugman, McMicken & Etchepare, 1989:513;Sultan & Coleman, 1989:298;Shah, 1996:175;Mactay, Perch, Markiewicz, Thaler, Challian, Goldberg, Kligerman & Weinstein, 1997:495;Ruhl, Gleich & Gluckman, 1997:1316Robertson, Gleich, Barrett & Gluckman, 2001:1364.…”

“…General swallowing characteristics noted on videofluoroscopy after total glossectomy with preservation of the larynx are an increase in oral transit time and stasis of food in the oral cavity, pharynx and above the superior oesophageal sphincter (Ruhl, Gleich & Gluckman, 1997:1317Furia et al 2000:379) …”