Abstract

Background and Objectives: The anterolateral thigh (ALT) flap is widely used in head and neck reconstruction, but the postoperative thigh sensory function lacks sufficient evaluation. The present study reports the postsurgical pain and cancer-related quality of life (QoL) in different stages of oral cancer patients receiving anterolateral thigh (ALT) flap reconstruction. Materials and Methods: Patients were subgrouped into postoperative early-, mid-, and late-recovery stages (postoperative 0.5–1 years, 1–2 years, and above 2 years) according to the time point of assessment. The QoL was examined using the EORTC C-30. Postsurgical donor and receipt site pain was evaluated through subjective reports and sensory tests. Results: Ninety-four patients were included in the final analysis. The functional and global health-related QoL significantly improved with time after surgery. However, spontaneous pain was reported in 57.7%, 72.3%, and 42% of patients in early-, mid-, and late-recovery stages, mainly in donor sites rather than in receipt sites. The highest incidence of donor site pain after ALT flap reconstruction in oral cancer surgery was in the mid-recovery stage but remained high in the late-recovery stage (56.8% and 36.7%, respectively). Conclusions: The postsurgical pain in the donor site might persist to or exhibit delayed onset one to two years postoperatively but is much improved after postoperatively two years later. A longer postsurgical follow-up for over two years for pain and sensory dysfunction is indicated.

Highlights

  • Immediate flap reconstruction for oral or maxillofacial defects resulting from radical resection for oral cancer is often needed

  • The purpose of this study is to investigate the characteristics and incidence of persistent postsurgical pain in oral cancer patients receiving anterolateral thigh (ALT) flap reconstruction, and the relationship with cancer-related quality of life (QoL) at different postoperative stages

  • The ALT flap is the mainstream in our institute for oral cancer reconstruction because of the advantages of a long vascular pedicle, large skin territory and less donor site morbidity

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Summary

Introduction

Immediate flap reconstruction for oral or maxillofacial defects resulting from radical resection for oral cancer is often needed. The type of reconstruction, type of surgery, and cancer stage may influence the postoperative quality of life (QoL) [1–3]. Townley et al [7] have reported a donor site assessment after ALT flap reconstruction, showing persistent pain in 15% of patients at postoperative six months. The present study reports the postsurgical pain and cancer-related quality of life (QoL) in different stages of oral cancer patients receiving anterolateral thigh (ALT) flap reconstruction. Spontaneous pain was reported in 57.7%, 72.3%, and 42% of patients in early-, mid-, and late-recovery stages, mainly in donor sites rather than in receipt sites. The highest incidence of donor site pain after ALT flap reconstruction in oral cancer surgery was in the mid-recovery stage but remained high in the late-recovery stage (56.8% and 36.7%, respectively). A longer postsurgical follow-up for over two years for pain and sensory dysfunction is indicated

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