Abstract
PurposeFree flap reconstructions following head and neck tumor resection are known to involve more than 50% rate of complications and other adverse events and up to 50% mortality during a 5-year follow-up.We aimed to examine the difference in the long-term quality of life (QoL) between the 2-year and 5-year assessments after free flap surgery for cancer of the head and neck.MethodsA total of 28 of the 39 eligible patients responded to the survey. QoL was assessed at 5 years after operation and compared with the assessment performed at 2 years after the operation using RAND-36, EORTC-C30 and H&N-35, and SWAL-QOL tools.ResultsThe criteria for poor QoL using RAND-36 tool was met in 11 (39.3%) patients in contrast to 4 (14.3%, P = 0.003) patients in the 2-year assessment. EORTC-C30 global score was decreased from 83.9 (SD16.4) to 64.6 (SD 24.0, P < 0.001) during the follow-up. In both RAND-36 and EORTC-C30 surveys, decline was found in physical and role functioning together with energy and emotional well-being domains. SWAL-QOL showed poor swallowing-related QoL in both assessments.ConclusionWe found a significant decline in QoL during a 5-year follow-up after free flap surgery for cancer of the head and neck.
Highlights
Free-flap reconstructions following head and neck tumor resection are known to involve more than 50% of complication and other adverse events rate, and up to 50% mortalityKrisztina Molnár and Siiri Hietanen have contributed to this work.It is previously demonstrated that quality of life (QoL) assessed with RAND-36 tool 2 years after the free flap operation is comparable with QoL of general population in patients without postoperative complications [3]
It is previously demonstrated that QoL assessed with RAND-36 tool 2 years after the free flap operation is comparable with QoL of general population in patients without postoperative complications [3]
Postoperative complications did not have an impact on the RAND-36 assessments at 5 years after the operation (Table 3)
Summary
It is previously demonstrated that QoL assessed with RAND-36 tool 2 years after the free flap operation is comparable with QoL of general population in patients without postoperative complications [3]. Other studies using different tools, such as EORTC QLQ-C30 have shown similar results [4,5,6]. Both patient- and treatment-related factors have shown to be linked to the assessed QoL [5, 6]. In one Finnish survey, the QoL was assessed with 15D-tool and the study showed a reduction in the QoL during a 5-year follow-up [7]
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