Assessment of functional outcomes and quality of life in patients with tongue cancer after partial glossectomy
Malamatenia Bourazani , Ioannis Papadiochos , Ourania Govina , Aristomenis I. Syngelakis , Pavlos Sarafis , Theocharis I. Konstantinidis T.
DOI: 10.54936/haoms26291103
SUMMARY: : Background: The tongue is the most common site of head and neck cancer. Tongue cancer and its therapy affect significantly patients’ quality of life (QoL) and functionality. Purpose: To determine the consequences of glossectomy as a treatment for tongue cancer on patients’ QoL and functionality. Material and methods: Between October 2021 and January 2022, we conducted a cross-sectional observational study of 40 patients with tongue cancer who underwent partial glossectomy and neck dissection in the University Clinic of Oral and Maxillofacial Surgery of General Hospital of Athens “Evaggelismos”. Patients completed the EORTC QLQ-C30 and QLQ-Η&Ν43 questionnaires and the Eastern Cooperative Oncology Group Performance Status Scale (ECOG-PS). Results: Patients were aged 23-83 years. The majority were men (70%), married (55.0%), holding a higher education degree (40.0%), working (52.5%), underwent postoperative radiotherapy and chemotherapy (50%) and reported the difficulty in speaking as the most serious problem (42.5%). According to the QLQ-Η&Ν43 questionnaire, fear of disease progression, problems with teeth, social eating and speech disorders had a negative influence on QoL. On the ECOG-PS, 95% of patients were grade 1 and 5% grade 2. A positive correlation was found between the increase of the number of symptoms (p<0.001), low educational level (p<0.001) and smoking (p=0.023) and low global health status/ QoL. Finally, no correlation was detected between QoL and use of adjuvant therapies (p>0.05). Conclusions: The main problems at least one year after partial glossectomy are difficulty in speaking and swallowing, as well as anxiety about disease progression. However, the majority of patients reported that their functionality had improved with time and evaluated their QoL as satisfactory.
KEY WORDS: ECOG scale, functionality, glossectomy, tongue cancer, quality of life.
REFERENCES
1. Ansarin M, Bruschini R, Navach V, Giugliano G, Calabrese L, Chiesa F, et al. Classification of Glossectomies: Proposal for tongue cancer resections. Head Neck. 2019;41(3):821-827.
2. Pyne JM, Dziegielewski PT, Constantinescu G, Dzioba A, O’Connell DA, Côté D et al. The Functional & Quality of Life Outcomes of Total Glossectomy with Laryngeal Preservation. Laryngoscope Investig Otolaryngol. 2020;5(5):853-859.
3. Riva G, Sapino S, Ravera M, Elia G, Pecorari G. Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas. Braz J Otorhinolaryngol. 2021; S1808-8694(21) 00:132-4.
4. Mannelli G, Arcuri F, Agostini T, Innocenti M, Raffaini M, Spinelli G. Classification of tongue cancer resection and treatment algorithm. J Surg Oncol. 2018;117(5):1092-1099.
5. Moore SR, Johnson NW, Pierce AM, Wilson DF. The epidemiology of tongue cancer: a review of global incidence. Oral Dis. 2000;6(2):75-84.
6. Zhang S, Wu S, Liu L, Zhu D, Zhu Q, Li W. Assessment of Quality of Life of Free Anterolateral Thigh Flap for Reconstruction of Tissue Defects of Total or Near-Total Glossectomy. Journal of Oncology. 2020;1–5.
7. NCCN Clinical Practice Guidelines in Oncology. Head and Neck Cancers NCCN Evidence Blocks. Version 1.2022 – December8, 2021.
8. Lacouture M, Sibaud V. Toxic Side Effects of Targeted Therapies and Immunotherapies Affecting the Skin, Oral Mucosa, Hair, and Nails. American Journal of Clinical Dermatology. 2018;19:31–39.
9. Goerling U, Stickel A. Quality of life in oncology. Psycho-oncology. 2014:137-52.
10. Cella DF, Tulsky DS. Measuring Quality of Life today: Methodological aspects. Oncology. 1990;4:29-38.
11. Konstantinidis T.Ι, Linardakis M, Samonis G, Philalithis A. Quality of life of patients with advanced cancer treated in a regional hospital in Greece. Hippokratia. 2016;20(2): 139-145.
12. Mystakidou K, Tsilika E, Parpa E, Kalaidopoulou O, Smyrniotis V, Vlachos L. The EORTC core questionnaire (QLQ-C30, version 3.0) in terminally ill cancer patients under palliative care: Validity and reliability in a Hellenic sample. Int J Cancer. 2001;94(1):135-139.
13. Kyriaki M, Eleni T, Efi P, Ourania K, Vassilios S, Lambros V. The EORTC core quality of life questionnaire (QLQ-C30, version 3.0) in terminally ill cancer patients under palliative care: validity and reliability in a Hellenic sample. Int J Cancer. 2001;94(1):135-139.
14. Singer S, Amdal D, Hammerlid E, Tomaszewska M, Castro Silva J, et al. EORTC Quality of Life and the EORTC Head and Neck Cancer Groups. International validation of the revised European Organisation for Research and Treatment of Cancer Head and Neck Cancer Module, the EORTC QLQHN43: Phase IV. Head & neck. 2019;41(6):1725–1737.
15. Spitzer WO, Dobson AJ. HALL AJ et aL. Measuring the quality of life of cancer patients: a concise QL-INDEX for use by physicians.Chron Dis. 1981;34:585- 97.
16. Glare P, Sinclair C, Downing M, Stone P, Maltoni M, Vigano A. Predicting survival in patients with advanced disease. European Journal of Cancer. 2008; 44(8):1146-1156.
17. Peng MT, Liu CT, Hung YS, Kao CY, Chang PH, Yeh KY, et al. Sequential Assessments of the Eastern Cooperative Oncology Group Performance Scale Enhance Prognostic Value in Patients with Terminally Ill Cancer Receiving Palliative Care. American Journal of Hospice and Palliative Medicine. 2014;33(5):471-476.
18. Nobis C-P, Otto S, Grigorieva T, Alnaqbi M, Troeltzsch M, et al. Elective neck dissection in unilateral carcinomas of the tongue: Unilateral versus bilateral approach. Journal of Cranio-Maxillo-Facial Surgery. 2017;45:579-584.
19. Hartl DM, Dauchy S, Escande C, Bretagne E, Janot F, Kolb F. Quality of life after free-flap tongue reconstruction. J Laryngol Otol. 2009;123(5):550-4.
20. McConnel FM, Logemann JA, Rademaker AW, Pauloski BR, Baker SR, Lewin J, et al. Surgical variables affecting postoperative swallowing efficiency in oral cancer patients: a pilot study. Laryngoscope. 1994;104(1 Pt 1):87-90.
21. Dzioba A, Aalto D, Papadopoulos-Nydam G, Seikaly H, Rieger J, Wolfaardt J, et al. Functional and quality of life outcomes after partial glossectomy: a multi-institutional longitudinal study of the head and neck research network. J Otolaryngol Head Neck Surg. 2017;46(1):56.
22. Ihara Y, Tashimo Y, Nozue S, Iizumi Y, Fukunishi Y, Saito Y, et al. Changes in Oral Function and Quality of Life in Tongue Cancer Patients Based on Resected Area. Asian Pac J Cancer Prev. 2021;22(8):2549-2557.
23. Ji JB, Cho YH, Song CM, Kim YH, Kim JT, Ahn HC, et al. Longterm functional outcomes after resection of tongue cancer: determining the optimal reconstruction method. Eur Arch Otorhinolaryngol. 2017;274:3751-6.
24. Canis M, Weiss BG, Ihler F, Hummers-Pradier E, Matthias C, Wolff HA. Quality of life in patients after resection of pT3 lateral tongue carcinoma: Microvascular reconstruction versus primary closure. Head Neck. 2016;38(1):89-94.
DOI: 10.54936/haoms26291103
SUMMARY: : Background: The tongue is the most common site of head and neck cancer. Tongue cancer and its therapy affect significantly patients’ quality of life (QoL) and functionality. Purpose: To determine the consequences of glossectomy as a treatment for tongue cancer on patients’ QoL and functionality. Material and methods: Between October 2021 and January 2022, we conducted a cross-sectional observational study of 40 patients with tongue cancer who underwent partial glossectomy and neck dissection in the University Clinic of Oral and Maxillofacial Surgery of General Hospital of Athens “Evaggelismos”. Patients completed the EORTC QLQ-C30 and QLQ-Η&Ν43 questionnaires and the Eastern Cooperative Oncology Group Performance Status Scale (ECOG-PS). Results: Patients were aged 23-83 years. The majority were men (70%), married (55.0%), holding a higher education degree (40.0%), working (52.5%), underwent postoperative radiotherapy and chemotherapy (50%) and reported the difficulty in speaking as the most serious problem (42.5%). According to the QLQ-Η&Ν43 questionnaire, fear of disease progression, problems with teeth, social eating and speech disorders had a negative influence on QoL. On the ECOG-PS, 95% of patients were grade 1 and 5% grade 2. A positive correlation was found between the increase of the number of symptoms (p<0.001), low educational level (p<0.001) and smoking (p=0.023) and low global health status/ QoL. Finally, no correlation was detected between QoL and use of adjuvant therapies (p>0.05). Conclusions: The main problems at least one year after partial glossectomy are difficulty in speaking and swallowing, as well as anxiety about disease progression. However, the majority of patients reported that their functionality had improved with time and evaluated their QoL as satisfactory.
KEY WORDS: ECOG scale, functionality, glossectomy, tongue cancer, quality of life.
REFERENCES
1. Ansarin M, Bruschini R, Navach V, Giugliano G, Calabrese L, Chiesa F, et al. Classification of Glossectomies: Proposal for tongue cancer resections. Head Neck. 2019;41(3):821-827.
2. Pyne JM, Dziegielewski PT, Constantinescu G, Dzioba A, O’Connell DA, Côté D et al. The Functional & Quality of Life Outcomes of Total Glossectomy with Laryngeal Preservation. Laryngoscope Investig Otolaryngol. 2020;5(5):853-859.
3. Riva G, Sapino S, Ravera M, Elia G, Pecorari G. Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas. Braz J Otorhinolaryngol. 2021; S1808-8694(21) 00:132-4.
4. Mannelli G, Arcuri F, Agostini T, Innocenti M, Raffaini M, Spinelli G. Classification of tongue cancer resection and treatment algorithm. J Surg Oncol. 2018;117(5):1092-1099.
5. Moore SR, Johnson NW, Pierce AM, Wilson DF. The epidemiology of tongue cancer: a review of global incidence. Oral Dis. 2000;6(2):75-84.
6. Zhang S, Wu S, Liu L, Zhu D, Zhu Q, Li W. Assessment of Quality of Life of Free Anterolateral Thigh Flap for Reconstruction of Tissue Defects of Total or Near-Total Glossectomy. Journal of Oncology. 2020;1–5.
7. NCCN Clinical Practice Guidelines in Oncology. Head and Neck Cancers NCCN Evidence Blocks. Version 1.2022 – December8, 2021.
8. Lacouture M, Sibaud V. Toxic Side Effects of Targeted Therapies and Immunotherapies Affecting the Skin, Oral Mucosa, Hair, and Nails. American Journal of Clinical Dermatology. 2018;19:31–39.
9. Goerling U, Stickel A. Quality of life in oncology. Psycho-oncology. 2014:137-52.
10. Cella DF, Tulsky DS. Measuring Quality of Life today: Methodological aspects. Oncology. 1990;4:29-38.
11. Konstantinidis T.Ι, Linardakis M, Samonis G, Philalithis A. Quality of life of patients with advanced cancer treated in a regional hospital in Greece. Hippokratia. 2016;20(2): 139-145.
12. Mystakidou K, Tsilika E, Parpa E, Kalaidopoulou O, Smyrniotis V, Vlachos L. The EORTC core questionnaire (QLQ-C30, version 3.0) in terminally ill cancer patients under palliative care: Validity and reliability in a Hellenic sample. Int J Cancer. 2001;94(1):135-139.
13. Kyriaki M, Eleni T, Efi P, Ourania K, Vassilios S, Lambros V. The EORTC core quality of life questionnaire (QLQ-C30, version 3.0) in terminally ill cancer patients under palliative care: validity and reliability in a Hellenic sample. Int J Cancer. 2001;94(1):135-139.
14. Singer S, Amdal D, Hammerlid E, Tomaszewska M, Castro Silva J, et al. EORTC Quality of Life and the EORTC Head and Neck Cancer Groups. International validation of the revised European Organisation for Research and Treatment of Cancer Head and Neck Cancer Module, the EORTC QLQHN43: Phase IV. Head & neck. 2019;41(6):1725–1737.
15. Spitzer WO, Dobson AJ. HALL AJ et aL. Measuring the quality of life of cancer patients: a concise QL-INDEX for use by physicians.Chron Dis. 1981;34:585- 97.
16. Glare P, Sinclair C, Downing M, Stone P, Maltoni M, Vigano A. Predicting survival in patients with advanced disease. European Journal of Cancer. 2008; 44(8):1146-1156.
17. Peng MT, Liu CT, Hung YS, Kao CY, Chang PH, Yeh KY, et al. Sequential Assessments of the Eastern Cooperative Oncology Group Performance Scale Enhance Prognostic Value in Patients with Terminally Ill Cancer Receiving Palliative Care. American Journal of Hospice and Palliative Medicine. 2014;33(5):471-476.
18. Nobis C-P, Otto S, Grigorieva T, Alnaqbi M, Troeltzsch M, et al. Elective neck dissection in unilateral carcinomas of the tongue: Unilateral versus bilateral approach. Journal of Cranio-Maxillo-Facial Surgery. 2017;45:579-584.
19. Hartl DM, Dauchy S, Escande C, Bretagne E, Janot F, Kolb F. Quality of life after free-flap tongue reconstruction. J Laryngol Otol. 2009;123(5):550-4.
20. McConnel FM, Logemann JA, Rademaker AW, Pauloski BR, Baker SR, Lewin J, et al. Surgical variables affecting postoperative swallowing efficiency in oral cancer patients: a pilot study. Laryngoscope. 1994;104(1 Pt 1):87-90.
21. Dzioba A, Aalto D, Papadopoulos-Nydam G, Seikaly H, Rieger J, Wolfaardt J, et al. Functional and quality of life outcomes after partial glossectomy: a multi-institutional longitudinal study of the head and neck research network. J Otolaryngol Head Neck Surg. 2017;46(1):56.
22. Ihara Y, Tashimo Y, Nozue S, Iizumi Y, Fukunishi Y, Saito Y, et al. Changes in Oral Function and Quality of Life in Tongue Cancer Patients Based on Resected Area. Asian Pac J Cancer Prev. 2021;22(8):2549-2557.
23. Ji JB, Cho YH, Song CM, Kim YH, Kim JT, Ahn HC, et al. Longterm functional outcomes after resection of tongue cancer: determining the optimal reconstruction method. Eur Arch Otorhinolaryngol. 2017;274:3751-6.
24. Canis M, Weiss BG, Ihler F, Hummers-Pradier E, Matthias C, Wolff HA. Quality of life in patients after resection of pT3 lateral tongue carcinoma: Microvascular reconstruction versus primary closure. Head Neck. 2016;38(1):89-94.
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