University Of Washington Quality Of Life Research Articles

Infrahyoid Myocutaneous Flap Versus Radial Forearm Free Flap in Treating Patients with cT1-2 Tongue Carcinoma

Our goal was to compare clinical and functional results of the infrahyoid myocutaneous flap (IMF) with those of the radial forearm free flap (RFFF) for partial tongue reconstruction. Between January 2005 and June 2012, patients who had received an IMF or a RFFF reconstruction for cT1-2 tongue carcinoma were included, their medical records were reviewed, and they were asked to complete the University of Washington Quality of Life (UW-QoL) version 4 questionnaire at least 12 months postoperatively. Compared to patients with a RFFF reconstruction, patients treated with an IMF had significantly shorter operation time (p<0.001), less hospital cost (p<0.001) and shorter postoperative stay (p<0.001). There were no apparent differences in other scales between the two groups. The mean composite score for the two groups was 88.4 (SD: 14.9) and 86.4 (SD: 15.3), respectively, the finding was not significant (p=0.784). Patients with an IMF reconstruction had significantly better shoulder function, there were no significant differences regarding other domains between the two groups. Compared to RFFF, IMF was a reliable procedure for partial tongue reconstruction.

Myofascial pain syndrome after head and neck cancer treatment: Prevalence, risk factors, and influence on quality of life.

Patients undergoing treatment for head and neck cancer may develop myofascial pain syndrome as sequelae. The purpose of this study was to determine the prevalence, risk factors, and quality of life (QOL) related to myofascial pain syndrome. This was a prospective study including patients with head and neck cancer with at least a 1-year disease-free interval. One hundred sixty-seven patients were analyzed, and myofascial pain syndrome was diagnosed in 20 (11.9%). In the multivariate analysis, hypopharyngeal tumors (odds ratio [OR] = 6.35; 95% confidence interval [CI] = 1.58-25.56) and neck dissection (OR = 3.43; 95% CI = 1.16-10.17) were independent factors for myofascial pain syndrome. The pain (p < .001) and shoulder domain (p < .001) as well as overall University of Washington Quality of Life (UW-QOL) score (p = .006) were significantly lower in the patients with myofascial pain syndrome. Myofascial pain syndrome was observed in 1 of 9 patients after head and neck cancer treatment and a worse QOL was observed among them. Tumor site and neck dissection were found to be risk factors for myofascial pain syndrome.

Emergent trends of perceived needs and concerns in long-term survivors of head and neck cancer using the patients concerns inventory

Introduction/Aim: The Patients Concerns Inventory (PCI) is a holistic needs assessment tool that aids head and neck cancer (HNC) patients disclose items of concern. The University of Washington Quality of Life (UWQOL) is a validated, HNC-specific health-related quality of life measure, which can also screen for significant problems. This study explored associations between PCI outcomes with UWQOL scores. Oral presentations for BAOMS Annual Scientific Meeting 2-4 July 2014, Edinburgh International Conference Centre, ScotlandBritish Journal of Oral and Maxillofacial SurgeryVol. 52Issue 8Preview Full-Text PDF

'What will I be like' after my diagnosis of head and neck cancer?

Consequences of treating head and neck cancer are reflected in health-related quality of life (HRQOL) patient-reported outcomes. HRQOL is an important outcome alongside survival and recurrence. However, relatively little HRQOL information is in a format that patients and oncology teams can easily interpret as a guide to likely outcomes following curative treatment. The study aim was to collate University of Washington Quality of Life (UW-QOL) questionnaires collected 1995-2012 at the Regional Head and Neck Surgical Unit with a view of summarizing key clinical-demographic influences on HRQOL outcomes at 2 years following diagnosis. Patients completing UW-QOL questionnaires at 9-60 months had their record closest to 2 years selected for cross-sectional analyses, while all questionnaires were analyzed to assess temporal trends. 65 % (1,134) of survivors to 9 months had a UW-QOL record in the cross-sectional analysis (median 23 months). Overall 1,349 completed 5,573 UW-QOL questionnaires. Various associations were seen, notably late overall clinical staging and treatment adversely associated with UW-QOL physical functioning domains. Logistic regression was used to better understand the predictive factors of UW-QOL outcome and determined the final formatting of tables for results. These tables provide important reference data about UW-QOL outcome at 2 years relevant to patients at the outset of their cancer journey. The increasing amount of HRQOL data allows for quite detailed subgroup analysis, which can help give patients and the clinical team a better understanding of likely long-term HRQOL outcomes. How this is best utilized in clinical care needs further evaluation.

Quality of Life, Shoulder Range of Motion, and Spinal Accessory Nerve Status in 5-Year Survivors of Head and Neck Cancer

To determine the association of neck dissection and radiation treatment for head and neck cancer (HNC) with subsequent shoulder range of motion (ROM) and quality of life (QOL) in 5-year survivors. A cross-sectional convenience sample. Otolaryngology clinics at tertiary care hospital and Veterans Affairs medical center. Five-year, disease-free survivors of HNC. Demographic and cancer treatment information was collected, including type of neck dissection (none, spinal accessory "nerve sparing," and "nerve sacrificing") and radiation. QOL questionnaires were administered, and shoulder ROM was measured. University of Washington Quality of Life (UWQOL), Functional Assessment of Cancer Therapy (FACT) Head and Neck, and Performance Status Scale for Head and Neck. Shoulder ROM measurements included abduction, adduction, flexion, extension, internal and external rotation. One hundred and five survivors completed QOL surveys; 85 survivors underwent additional shoulder ROM evaluations. The nerve sacrifice group exhibited significantly poorer scores for UWQOL measures of disfigurement, level of activity, recreation and/or entertainment, speech and shoulder disability, and willingness to eat in public, FACT functional well-being, and FACT Head and Neck (P< .05). Shoulder ROM for flexion and abduction was poorest in the nerve sacrifice group (P< .05). Radiation was associated with significantly worse UWQOL swallowing (P< .05), but no other differences were found for QOL or ROM measurements. Decreased QOL scores were associated with decreased shoulder flexion and abduction (P< .05). Survivors with decreased shoulder abduction had significantly (P< .05) worse scores in disfigurement, recreation and/or entertainment, employment, shoulder disability, and FACT emotional well-being. Sparing the spinal accessory nerve during neck dissection is associated with significantly less long-term shoulder disability in 5-year survivors of HNC. QOL measures demonstrated the highest level of function in the no dissection group, an intermediate level of functioning with nerve sparing, and poorest function when the nerve is sacrificed. Decreased shoulder flexion and abduction is associated with reduced QOL in long-term survivors of HNC.

Comparison of functional outcomes and quality of life between transoral surgery and definitive chemoradiotherapy for oropharyngeal cancer

The purpose of this study was to compare patient-reported outcomes between patients treated by initial transoral resection versus definitive chemoradiotherapy for oropharyngeal cancer. Thirty-one patients with oropharyngeal cancer treated by initial transoral CO2 laser microsurgery (n = 16) or robotic surgery (n = 15) followed by postoperative radiotherapy were identified. Each patient was matched to 1 control patient treated by definitive chemoradiotherapy. The University of Washington Quality of Life (UW-QOL) scores at 1 year were compared. No significant differences were observed in any of the UW-QOL functional domains at 1 year with the exception of swallowing (91.5 vs 72.1; p = .01). Twenty-three of 31 patients (74%) treated by transoral surgery reported swallowing "as well as ever," versus 10 of 31 patients (32%) treated by chemoradiotherapy. Similar quality of life was observed among patients treated by transoral surgery or chemoradiotherapy. Although the rates of subjective swallowing dysfunction were higher among the latter, confounding biases must be considered.

Dose reduction to dysphagia/aspiration-related structures (DARS) in patients receiving induction chemotherapy (IC) followed by concurrent chemoradiation therapy (CCRT) for locally advanced squamous cell carcinoma of the head and neck (LASCCHN)

Radiation dose to dysphagia/aspiration-related structures (DARS) during definitive concurrent chemoradiotherapy (CCRT) is associated with chronic dysphagia and percutaneous endoscopic gastrostomy (PEG) tube dependency. Induction chemotherapy (IC) for locally advanced squamous cell carcinoma of the head and neck (LASCCHN) has been shown to decrease primary tumor and nodal size prior to CCRT, and we have begun to reduce gross tumor volumes (GTVs) for these patients based on post-IC scans. We evaluated dose reductions to DARS attributable to these reduced target volumes. Retrospective study of 41 consecutive LASCCHN patients treated with IC followed by CCRT. Patients were treated with docetaxel, cisplatin, and 5-fluorouracil (TPF) or another taxane-based regimen followed by CCRT with 70 Gy intensity-modulated radiation therapy (IMRT) with target volumes modified based on post-IC simulation scans. No dose constraints were placed on DARS. Patients’ pre-IC neck imaging scans were imported into our planning software, GTVs were contoured, and hypothetical pre-IC plans were generated. We compared dose volume histograms (DVHs) of the hypothetical pre-IC plans to the actual treatment plans for dose to DARS including the pharyngeal constrictor muscles and proximal esophagus, evaluating mean/max. dose, V50, and V60 with paired t tests. Late dysphagia was assessed via the University of Washington Quality of Life (UWQOL) survey and PEG tube dependency. Disease control was assessed with Kaplan–Meier analysis. Statistically significant dose reductions from pre-IC to post-IC scans were observed for superior pharyngeal constrictor (SPC) D mean (−1.1 Gy, P = 0.001), SPC D max (−1.1 Gy, P < 0.001), middle pharyngeal constrictor (MPC) D max (−1.5 Gy, P = 0.01), MPC V60 (−11.5 %, P = 0.001), total pharyngeal constrictor (TPC) D mean (−1.1 Gy, P < 0.001), TPC D max (−0.9 Gy, P < 0.001), TPC V60 (−2.5 %, P = 0.035), and PE V60 (−8.1 %, P = 0.049). In the 30 patients with UWQOL surveys ≥ 6 months posttreatment, mean swallowing score was 79 (scale 0–100). Two-year locoregional control (LRC) was 92 % (median follow-up 22 months). Modifying tumor target volumes post-IC in LASCCHN patients results in statistically significant, modest dose reduction to DARS.

Quality of Life Among Long-Term Survivors of Head and Neck Cancer Treated by Intensity-Modulated Radiotherapy

Radiation therapy to the head and neck has traditionally been associated with adverse effects that can affect oral health and physical functioning. Although intensity-modulated radiotherapy (IMRT) has been widely adopted as a means of decreasing toxic effects, limited clinical data exist on its potential effect on long-term quality of life. To analyze quality of life among long-term survivors of head and neck cancer treated with IMRT. This cross-sectional analysis studied 50 consecutive long-term survivors of head and neck cancer from a comprehensive cancer center who had previously undergone IMRT that required bilateral neck irradiation for locally advanced disease. All patients were clinically without evidence of recurrent disease and had at least 5 years of follow-up. The University of Washington Quality of Life (UW-QOL) scores were reviewed for all study participants. The UW-QOL questionnaire consists of 12 domains that pertain to the degree of quality of life in the categories of pain, appearance, activity, recreation, swallowing, chewing, speech, shoulder function, taste, saliva, mood, and anxiety. Five years after completion of IMRT, 42 patients (84%) reported that their health-related quality of life was "much better" or "somewhat better" than at the time of cancer diagnosis. With respect to recent health-related quality of life during the preceding 7 days at the time of completing the UW-QOL questionnaire, 40 patients (80%) treated with IMRT reported "outstanding" or "very good" levels of functioning. Five years after completion of treatment, 41 (82%) rated their overall quality of life as "outstanding" or "very good." The lowest domain score on the UW-QOL questionnaire at 5 years pertained to salivary dysfunction. However, 42 patients (84%) reported saliva "of normal consistency" or "less saliva than normal but enough" compared with 8 (16%) reporting "too little saliva." No patient reported having "no saliva." Our findings add to the body of literature that supports the acceptance of IMRT as standard treatment for head and neck cancer. The fact that most 5-year survivors were satisfied with their quality of lives points to the ability of IMRT to preserve long-term functioning.

Measures of Health-related Quality of Life in Huge Ameloblastoma Young Patients after Mandible Reconstruction with Free Fibula Flap

Mandibular resection has been associated with a poor health-related quality of life (HRQOL), particularly in young patients with free fibula flap requiring defect reconstruction.¡¡The purpose of our study was to evaluate HRQOL of young patients who have had mandibular resections of huge ameloblastoma and free fibula flap reconstruction. The present study assessed 32 young patients who had undergone immediate mandible reconstruction with free fibula flap for huge ameloblastoma using the University of Washington Quality of Life (UW-QOL) Questionnaire and 49-item Oral Health Impact Profile (OHIP-49). Thirty-two of the forty-seven questionnaires were returned (68.08%). Of the 12 disease-specific domains on the UW-QOL, the best 3 scores from the patients were for shoulder, pain and taste, and the worst 3 scores were for chewing, anxiety and mood. On the OHIP-49, the lowest-scoring domain was physical pain, followed by handicap and social disability. A significant effect was found on the HRQOL of young patients with huge ameloblastoma who had undergone immediate mandible reconstruction with free fibula

Health-related quality of life after mandibular resection for oral cancer: Reconstruction with free fibula flap

Objectives: Mandibular resection for oral cancer is often necessary to achieve an adequate margin of tumor clearance. Mandibular resection has been associated with a poor health-related quality of life (HRQOL), particularly before free fibula flap to reconstruct the defect. The aim of this study was to evaluate health-related quality of life in patients who have had mandibular resections of oral cancer and reconstruction with free fibula flap. Study Designs: There were 115 consecutive patients between 2008 and 2011 who were treated by primary surgery for oral squamous cell carcinoma, 34 patients had a mandibular resection. HRQOL was assessed by means of the 14-item Oral Health Impact Profile (OHIP-14) and University of Washington Quality of Life (UW-QOL) questionnaires after 12 months postoperatively. Results: In the UW-QOL the best-scoring domain was mood, whereas the lowest scores were for chewing and saliva. In the OHIP-14 the lowest-scoring domain was social disability, followed by handicap, and psychological disability. Conclusions: Mandible reconstruction with free fibula flap would have significantly influenced on patients’quality of life and oral functions. The socio-cultural data show a fairly low level of education for the majority of patients. Key words:Health-related quality of life, free fibula flap, mandibulectomy, UW-QOL, OHIP-14.

Differences of salivary cortisol levels between long-term and short-term wearers of dento-maxillary prosthesis due to head and neck cancer resection

PurposeThe purpose of this study was to use cortisol awakening response (CAR) to investigate the differences in daily life stress experienced by individuals wearing either a long-term (LT) or a short-term (ST) dento-maxillary prosthesis following head and neck cancer (HNC) resection. Also we used the University of Washington Quality of Life (UW-QOL) version 4 questionnaire to evaluate the differences in quality of life (QOL) scores between ST and LT wearers of a dento-maxillary prosthesis. MethodsSalivary samples were collected from 11 LT and 10 ST prosthesis wearers on two consecutive days at two time points, immediately after waking up (T0) and 30min later (T30), by passive drool collection. Cortisol levels were measured using a high sensitivity salivary cortisol enzyme immunoassay kit (Salimetrics, LLC, State College, PA, USA) and CAR (the differences between the cortisol levels at T0 and T30) was compared between LT and ST prosthesis wearers. In addition, both the groups completed the UW-QOL questionnaire and the scores were compared. ResultsA significant difference was observed in CAR between the two groups. CAR of the ST prosthesis wearers was significantly lower compared with that of the LT prosthesis wearers; moreover, the ST prosthesis wearers revealed significantly lower total UW-QOL scores and there were significant differences in appearance, activity, recreation, speech, and anxiety. ConclusionWithin the limitations of this study, the findings suggest that individuals wearing ST dento-maxillary prostheses following HNC resection experience some sort of daily life stress and complicated socio-demographic factors may influence their QOL.

Assessment of quality of life and sociocultural aspects in patients with ameloblastoma after immediate mandibular reconstruction with a fibular free flap

Our aim was to evaluate the quality of life (QoL) in patients with ameloblastoma who had been treated by immediate mandibular reconstruction with a fibular free flap, and to analyse the association between QoL and their sociocultural and medical characteristics. We assessed the QoL outcomes of 33/45 patients using the University of Washington quality of life (UW-QoL) questionnaire and the 14-item Oral Health Impact Profile (OHIP-14). Thirty-three of the 45 questionnaires were returned (73%). In the UW-QoL the best-scoring domain was “shoulder”, whereas the lowest scores were for “chewing” and “activity”. In the OHIP-14 the lowest-scoring domain was “handicap”, followed by “social disability” and “psychological discomfort”. Mandibular reconstruction with a fibular free flap significantly influenced the patients’ QoL and oral function. Their sociocultural data showed that most patients had a fairly low level of education.

Assessment of the Quality of Life of Patients With Oral Cancer After Pectoralis Major Myocutaneous Flap Reconstruction With a Focus on Speech

The aim of the present study was to evaluate the quality of life (QoL) of patients with oral cancer who had undergone resection of the tongue and floor of the mouth and reconstruction with the pectoralis major flap. The present study assessed 21 patients who had undergone pectoralis major flap reconstruction using the University of Washington QoL, version 4, questionnaire. A nonparametric Mann-Whitney U test was used to analyze the data. Of the 12 disease-specific domains, the best 3 scores from the patients were for pain, saliva, and anxiety, and the worst 3 scores were for taste, chewing, and swallowing. The mean UW-QoL composite score was 73.4. Swallowing was considered to be the most important issue within the previous 7 days, followed by chewing and speech. Those patients who had undergone wider excision had poorer speech. A significant effect was found on the QoL of patients with oral cancer who had undergone resection of the tongue and floor of the mouth with pectoralis major flap reconstruction.

Measures of health-related quality of life and socio-cultural aspects in young patients who after mandible primary reconstruction with free fibula flap

BackgroundThe reconstruction of mandibular defects after trauma or tumor resection is one of the most challenging problems facing reconstructive surgeons. Although the primary intended outcome of surgery to treat head-and-neck malignancies is still the disease-free survival of the patient, health-related quality of life (HRQOL) is now seen as an essential secondary outcome. This study aims to evaluate HRQOL outcomes in young patients undergoing primary mandible reconstruction with free fibula flap and to collect information about their socio-cultural situation.MethodsThe HRQOL outcomes of 25 young patients after primary mandible reconstruction with free fibula flap for mandible malignancies were assessed using the Medical Outcomes Study-Short Form-36 (MOS SF-36) and University of Washington Quality of Life (UW-QOL) questionnaires 12 months postoperatively.ResultsUsing the UW-QOL questionnaire, the best-scoring domain was ‘pain’, whereas ‘chewing’ and ‘anxiety’ were given the lowest scores. Using the MOS SF-36 questionnaire, the best-scoring domain was ‘physical functioning’, while ‘bodily pain’ and ‘general health’ also scored well.ConclusionsMandible reconstruction with fibula flap will significantly influence a young patient’s HRQOL. Young patients pay more attention to postoperative facial appearance; this should be considered in surgical planning. The socio-cultural data show a fairly low level of education for the majority of patients.

Development of the Greek version of the University of Washington Quality of Life questionnaire for patients with head and neck cancer

The University of Washington Quality of Life (UW-QOL) questionnaire, created in 1993 to evaluate health related quality of life, has been widely used in English-speaking populations and translated and validated in other languages. The aim of the present study was to carefully translate and psychometrically validate the UW-QOL questionnaire in Greek. The revised version of the questionnaire was obtained by forward and backward translation of the original English version, according to internationally accepted guidelines. Validation was performed in 120 patients with head and neck cancer treated in a Greek Anticancer Institute in Athens, during their follow-up visits. Eligible patients completed the Greek version of the questionnaire and two other previously validated quality of life questionnaires (EORTC QLQ H&N35 and C-30). Related data and the patients' demographics were extracted from the patient's notes. Strong internal consistency (mean Cronbach α value of 0.83) was shown, with good construct validity. Statistically significant differences were noted between tumour staging and treatment modality and global quality of life. Strong correlation was shown between previously validated EORTC questionnaires and the translated UW-QOL questionnaire. In conclusion, the Greek version of the UW-QOL questionnaire appears to be culturally appropriate and psychometrically valid.

Vascularized free forearm flap versus free anterolateral thigh perforator flaps for reconstruction in patients with head and neck cancer: Assessment of quality of life

This study investigated the quality of life of Chinese patients with malignant tumors who had undergone immediate free flap reconstruction surgery. In addition, we compared 2 groups of patients: those who had received radial forearm free flap surgery and others who had received free anterolateral thigh perforator flap surgery. Quality of life was assessed using the Medical Outcomes Study-Short Form-36 (MOS SF-36) and the University of Washington Quality of Life (UW-QOL) questionnaires 12 months after reconstruction. A total of 121 of 163 questionnaires were returned (74.2%). There were significant differences between the 2 groups in the T classification (p < .005). Patients reconstructed with free anterolateral thigh perforator flaps performed better in the appearance and shoulder domains, and the role emotion and social functioning domains. Using either radial forearm free flaps or free anterolateral thigh perforator flaps for reconstruction of head and neck defects after cancer resection significantly influences a patient's quality of life.

OP070: Emergent trends of perceived needs and concerns in long-term survivors of head and neck cancer using the patients concerns inventory

Objectives The Patients Concerns Inventory (PCI) is a holistic needs assessment tool to help patients disclose items of concern during routine clinical consultations. The University of Washington Quality of Life (UWQOL) is a validated, HNC-specific HRQOL, which can also screen for patients with significant problems. This study explored associations between PCI outcomes with UWQOL scores. Methods A cross-sectional study of 674 HNC patients (mean age 64 years; 67% men) who completed the HNC-PCI and UWQOL was undertaken. Relationships between HNC-PCI domain selection, UWQOL scores and patient/clinical characteristics were investigated, with statistical significance obtained as appropriate. Results Most (70%, 472) completed HNC-PCI only once (median, 39 months), while 30% (202) completed more than once. On first completing the HNC-PCI (median, 32 months from surgery/diagnosis), items under Physical and functional and Psychological and Emotional well-being/Spiritual domains were selected in 81% and 58%, respectively. When completing a second HNC-PCI, relatively fewer items per domain. Younger patients and those treated by radiotherapy were more likely to select from Psychological and Emotional well-being/Spiritual and Social care/Social well-being domains. Those treated by adjuvant radiotherapy and the larynx subsite were more likely to select from Social care/Social well-being domain. Clear associations were found between four HNC-PCI domains selected with UWQOL subscale scores, and also with the single item UWQOL and overall QOL, where patients in worse condition were more likely to select items within each HNC-PCI domains. Conclusions Emerging trends suggest that certain clinical-pathological factors are associated with specific presentation of perceived needs/concerns. The association between perceived needs with HRQOL outcomes endorses the importance of meeting unmet needs in long-term HNC survivors even though there is a suggestion that the unmet needs may reduce with time.

OP069: Changes quality of life in newly diagnosed oral cavity cancer patients – Overall trajectory, related factors and sub-patterns of QOL during the first 12-month of diagnosis

The diagnosis of oral cavity cancers and treatments/disease related distress from the oral–facial areas may influence patients’ quality of life (QOL). The purposes of this study were to (1) examine the changes of symptoms (physical distress), psychological distress (depression and anxiety) and QOL during the first 12 months of being diagnosed as oral cavity cancer, (2) identify factors related to overall QOL, and (3) identify QOL sub-patterns in newly diagnosed oral cavity cancer patients in Taiwan. A 12-month prospective longitudinal study was conducted to assess the changes of symptom, psychological distress and QOL. Subjects were recruited from three medical centers in Northern Taiwan and were assessed on 6 time points (days before operation, 1, 2, 3, 6 12 months post surgery/T1–T6, respectively). The psychometrically validated Chinese version instruments were used, including (1) Symptom Severity Scale (SSS), (2) Hospital Anxiety and Depression Scale (HADS), (3) University of Washington Quality of Life (UW-QOL), and (4) Background Information Form. In addition to the descriptive statistics, the Generalized Estimating Equations (GEE) was applied to identify the overall QOL related factors. The latent class growth modeling was used to identify the potential QOL sub-patterns. Data were collected after Institute Review Board (IRB) approval and patients’ consents. A total of 150 eligible subjects completed the 12 months assessments. Overall, patients reported moderate levels of QOL with the worst QOL during the first three months post-surgery (T2–T4). However, some delayed problems were also reported, including dry mouth, swallowing problem, chewing dysfunction and employment concern. Patients having reconstruction surgery, more advanced cancer stage, higher levels of depression and symptom severity, without job, and having lower education level were found to have lower levels of QOL across the time. QOL sub-patterns were also identified. Results of the study provide the evidence-based information to health care professionals to better help oral cavity cancer patients with timely interventions. Future studies should also test the effects of these interventions on improving patients’ QOL.

Comparison between anterolateral thigh perforator free flaps and pectoralis major pedicled flap for reconstruction in oral cancer patients-A quality of life analysis

The aim of this study was to compare the differences between anterolateral thigh perforator free flaps (ALTFF) and pectoralis major myocutaneous flap (PMMF) for reconstruction in oral cancer patients. Method and Patients: who received free flap or PMMF reconstruction after ablation surgeries were eligible for the current study. The patients’ demographic data, medical history, and quality of life scores(Medical Outcomes Study-Short Form-36 (MOS SF-36) and the University of Washington Quality of Life (UW-QOL) questionnaires were collected. Results: 81 of 118 questionnaires were returned (68.64%). There was significant differences between two groups in the gender (P<0.005). Patients reconstructed with ALTFF had better appearance domains and better shoulders domains, in addition to better role emotion domains. Conclusions: Using either PMMF or ALTFF for reconstruction of oral defects after cancer resection significantly influences a patient’s quality of life. Data from this study provide useful information for physicians and patients during their discussion of reconstruction modalities for oral cancers. Key words:Quality of life, ALTFF,PMMF, oral cancer.

Assessment of quality of life of patients with oral cavity cancer who have had defects reconstructed with free anterolateral thigh perforator flaps

The aim of this study was to evaluate quality of life (QoL) in patients who have had resections of oral cancer and reconstruction by free anterolateral thigh perforator flaps. QoL was assessed by the 14-item Oral Health Impact Profile (OHIP-14) and the University of Washington Quality of Life (UW-QoL) questionnaires 12 months postoperatively.Fifty-one of the 69 questionnaires were returned (74%). In the UW-QoL the best-scoring domain was pain, whereas the lowest scores were for chewing, saliva, and taste. In the OHIP-14 the lowest-scoring domain was handicap, followed by psychological disability, and social disability. Free anterolateral thigh perforator flaps for reconstruction of defects of the head and neck after resection for cancer significantly influenced the patients’ quality of life.