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Long-term quality of life and psycho-social outcomes after oropharyngeal cancer surgery and radial forearm free-flap reconstruction: A GETTEC prospective multicentric study

Alexandre Bozec 1 Pierre Demez 2 Jocelyn Gal 3 Emmanuel Chamorey 4 Marie-Yolande Louis 5 David Blanchard 5, 6 Dominique de Raucourt 5, 6 Jean-Claude Mérol 7 Esteban Brenet 8 Olivier Dassonville 9 Gilles Poissonnet 4 José Santini 4 Frédéric Peyrade 4 Karen Benezery 4 Maria Lesnik 10 Etienne Berta 11 Pierre Ransy 2 Emmanuel Babin 12, 13, 14
Abstract :
Objective
To assess long-term quality of life (QoL) and psycho-social outcomes, and to determine their predictive factors after oropharyngeal cancer (OPC) surgery and radial forearm free-flap (RFFF) reconstruction. Methods
Patients who had undergone OPC surgery and RFFF reconstruction who were still alive and disease-free at least 1 year after surgery were enrolled in this prospective multicentric study. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core (QLQ-C30) and Head and Neck Cancer (QLQ-H&N35) QoL questionnaires, the Voice Handicap Index (VHI-10) questionnaire and the Hospital Anxiety and Depression Scale (HADS). The level of dysphagia was evaluated using the Dysphagia Handicap Index (DHI) and the Dysphagia Outcomes and Severity Scale (DOSS). Predictive factors of these clinical outcomes were determined in univariate and multivariate analysis.

Results
A total of 58 patients were included in this study. Long-term QoL and functioning scales scores were well-preserved (all superior to 70%). Main persistent symptoms were fatigue, reduced sexuality and oral function-related disorders (swallowing, teeth, salivary and mouth-opening problems). HADS anxiety and depression scores were 7.2 and 5.4, respectively. Twenty-one (36%) patients presented an anxiodepressive disorder (HADS global score ≥ 15). Among the 21 patients who were still working before surgery, 11 (52%) had returned to work at the time of our study. The HADS global score (p < 0.001) was the main predictor of QoL, VHI-10 and DOSS scores.

Conclusions
Psychological distress is the main determinant of long-term QoL and is therefore of critical importance in the multidisciplinary management of OPC patients.
Document type :
Journal articles
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https://hal.univ-reims.fr/hal-02453752
Contributor : Valerian Dormoy <>
Submitted on : Friday, January 24, 2020 - 8:43:43 AM
Last modification on : Wednesday, August 19, 2020 - 11:18:52 AM

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Alexandre Bozec, Pierre Demez, Jocelyn Gal, Emmanuel Chamorey, Marie-Yolande Louis, et al.. Long-term quality of life and psycho-social outcomes after oropharyngeal cancer surgery and radial forearm free-flap reconstruction: A GETTEC prospective multicentric study. Surgical Oncology, Elsevier, 2018, 27 (1), pp.23-30. ⟨10.1016/j.suronc.2017.11.005⟩. ⟨hal-02453752⟩

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