Longitudinal health-related quality of life after mandibular resection for oral cancer: A comparison between rim and segment
Longitudinal health-related quality of life after mandibular resection for oral cancer: A comparison between rim and segment
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DOI：
10.1002/hed.10351
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发表时间：
2004-01-01
影响因子：
2.9
通讯作者：
Vaughan, ED
中科院分区：
文献类型：
--
作者：
Rogers, SN;Devine, J;Vaughan, ED
背景口腔癌的下颌骨切除术通常是必要的，以达到足够的肿瘤清除边缘。下颌骨节段切除术与健康相关生活质量（HRQOL）较差相关，特别是在复合游离组织移植重建缺损之前。很少有文献发表比较主观缺陷的节段性与边缘切除。本研究的目的是使用一个有效的头部和颈部HRQOL调查问卷，比较边缘和下颌骨节段性切除患者的口腔癌初次手术。在1995年至1999年期间，共有224名连续患者接受了口腔鳞状细胞癌的初次手术治疗。123例未进行下颌骨切除，44例进行了边缘切除，57例进行了节段性切除。在治疗前、治疗6个月、12个月和18个月后进行华盛顿大学生活质量问卷（UW-QOL）。术前，接受节段性切除术的患者报告了明显更多的疼痛、咀嚼问题和较低的UW-QOL综合评分。术后，节段组在所有时间点的评分往往更差，特别是在外观、吞咽、娱乐和咀嚼方面;然而，边缘和节段之间的差异仅见于无辅助放疗的较小切除。肿瘤直径> 4cm时，肿瘤边缘与肿瘤节段间差异不大。下颌骨节段性切除及复合游离组织移植重建后，UW-QOL评分相对较好。边缘和节段之间的唯一差异是在没有放疗的小切除术中观察到的，其中一些差异反映在基线差异中。(C)2004 Wiley Periodicals，Inc.
Background. Mandibular resection for oral cancer is often necessary to achieve an adequate margin of tumor clearance. Segmental mandibulectomy has been associated with a poor health-related quality of life (HRQOL), particularly before composite free tissue transfer to reconstruct the defect. Little is published in the literature contrasting the subjective deficit of segmental compared with rim resection. The aim of this study was to use a validated head and neck HRQOL questionnaire to compare rim and segmental mandibular resection in patients having primary surgery for oral cancer.Method. There were 224 consecutive patients between 1995 and 1999 who were treated by primary surgery for oral squamous cell carcinoma. One hundred twenty-three had no mandibular resection, 44 had a rim resection, and 57 had a segmental resection. The University of Washington Quality of life questionnaire (UW-QOL) was administered before treatment, at 6 months, 12 months, and after 18 months.Results. Preoperatively, patients undergoing segmental resection reported significantly more pain, chewing problems, and a lower composite UW-QOL score. Postoperatively, the segment group tended to score worse at all time points, particularly in appearance, swallowing, recreation, and chewing; however, the difference between rim and segment was only seen in smaller resections without adjuvant radiotherapy. Little difference was seen between rim or segment for tumors 4 cms.Conclusions. After segmental mandibulectomy and reconstruction using composite free tissue transfer, the UW-QOL scores were relatively good. The only difference between rim and segments was noted in the small resections without radiotherapy, and some of this was reflected in differences at baseline. (C) 2004 Wiley Periodicals, Inc.