Patient-reported outcomes following head and neck cancer are of great importance given the functional, psychological, and social impacts of the disease and its treatment. With an increasing number of publications on HRQOL following head and neck cancer and a growing awareness of the potential role of HRQOL in practice, it was our aim to investigate head and neck functional mobility that is often not taking into account in HRQOL scores.
In this prospective study, three different groups of 32 patients each were included. Any patient who had histologically confirmed invasive OSCC in the anterior floor of the mouth was eligible. All patients were examined by a standardized test assessing function, including the distance of mouth opening, extension, flexion, and rotation of the head.
A total of 96 patients were included in this study. The mean age was 62.79 ± 8.93 years. Head and neck mobility measured in patients is presented and analyzed. Compared to the baseline, a significant reduction of mouth opening and head and neck mobility was noted in all groups.
Although both treatment options (surgery and surgery with radiotherapy) were performed according to the tumor stage of patients, there are significant differences in the functional outcome of these patients as observed in this study. There is a lack of a measuring instrument that will be the “gold standard” in the assessment of head and neck functional mobility. This study will allow the reflection of our current practice and may stimulate further well-designed prospective studies.
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Airoldi M, Garzaro M, Raimondo L, Pecorari G, Giordano C, Varetto A et al (2011) Functional and psychological evaluation after flap reconstruction plus radiotherapy in oral cancer. Head Neck 33(4):458–468
Bengtson BP, Schusterman MA, Baldwin BJ, Miller MJ, Reece GP, Kroll SS et al (1993) Influence of prior radiotherapy on the development of postoperative complications and success of free tissue transfers in head and neck cancer reconstruction. Am J Surg 166(4):326–330
Chambers MS, Garden AS, Kies MS, Martin JW (2004) Radiation-induced xerostomia in patients with head and neck cancer: pathogenesis, impact on quality of life, and management. Head Neck 26(9):796–807
Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350(19):1937–1944
Dassonville O, Poissonnet G, Chamorey E, Vallicioni J, Demard F, Santini J et al (2008) Head and neck reconstruction with free flaps: a report on 213 cases. Eur Arch Otorhinolaryngol 265(1):85–95
Eich HT, Loschcke M, Scheer M, Kocher M, Bongartz R, Wacker S et al (2008) Neoadjuvant radiochemotherapy and radical resection for advanced squamous cell carcinoma of the oral cavity. Outcome of 134 patients. Strahlenther Onkol 184(1):23–29
Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W et al (2003) Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 349(22):2091–2098
Hassanein KA, Musgrove BT, Bradbury E (2001) Functional status of patients with oral cancer and its relation to style of coping, social support and psychological status. Br J Oral Maxillofac Surg 39(5):340–345
Jones NF, Jarrahy R, Song JI, Kaufman MR, Markowitz B (2007) Postoperative medical complications–not microsurgical complications–negatively influence the morbidity, mortality, and true costs after microsurgical reconstruction for head and neck cancer. Plast Reconstr Surg 119(7):2053–2060
Karvonen-Gutierrez CA, Ronis DL, Fowler KE, Terrell JE, Gruber SB, Duffy SA (2008) Quality of life scores predict survival among patients with head and neck cancer. J Clin Oncol 26(16):2754–2760
Macfarlane GJ, McBeth J, Silman AJ (2001) Widespread body pain and mortality: prospective population based study. BMJ 323(7314):662–665
McBeth J, Silman AJ, Macfarlane GJ (2003) Association of widespread body pain with an increased risk of cancer and reduced cancer survival: a prospective, population-based study. Arthritis Rheum 48(6):1686–1692
Mohr C, Bohndorf W, Carstens J, Harle F, Hausamen JE, Hirche H et al (1994) Preoperative radiochemotherapy and radical surgery in comparison with radical surgery alone. A prospective, multicentric, randomized DOSAK study of advanced squamous cell carcinoma of the oral cavity and the oropharynx (a 3-year follow-up). Int J Oral Maxillofac Surg 23(3):140–148
Mücke T, Wagenpfeil S, Kesting MR, Hölzle F, Wolff KD (2009) Recurrence interval affects survival after local relapse of oral cancer. Oral Oncol 45(8):687–691
Mücke T, Wolff KD, Wagenpfeil S, Mitchell DA, Hölzle F (2010) Immediate microsurgical reconstruction after tumor ablation predicts survival among patients with head and neck carcinoma. Ann Surg Oncol 17(1):287–295
Mücke T, Konen M, Wagenpfeil S, Kesting MR, Wolff KD, Hölzle F (2011a) Low-dose preoperative chemoradiation therapy compared with surgery alone with or without postoperative radiotherapy in patients with head and neck carcinoma. Ann Surg Oncol 18:2739–2747
Mücke T, Hölzle F, Wagenpfeil S, Wolff KD, Kesting M (2011b) The role of tumor invasion into the mandible of oral squamous cell carcinoma. J Cancer Res Clin Oncol 137(1):165–171
Nordgren M, Hammerlid E, Bjordal K, Ahlner-Elmqvist M, Boysen M, Jannert M (2008) Quality of life in oral carcinoma: a 5-year prospective study. Head Neck 30(4):461–470
Pignon JP, Bourhis J, Domenge C, Designe L (2000) Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet 355(9208):949–955
Poulsen MG, Denham JW, Peters LJ, Lamb DS, Spry NA, Hindley A et al (2001) A randomised trial of accelerated and conventional radiotherapy for stage III and IV squamous carcinoma of the head and neck: a Trans-Tasman Radiation Oncology Group Study. Radiother Oncol 60(2):113–122
Rogers SN, Lowe D, Patel M, Brown JS, Vaughan ED (2002) Clinical function after primary surgery for oral and oropharyngeal cancer: an 11-item examination. B J Oral Maxillofac Surg 40(1):1–10
Shah JP, Gil Z (2009) Current concepts in management of oral cancer–surgery. Oral Oncol 45(4–5):394–401
Tschiesner U, Schuster L, Strieth S, Harreus U (2011) Functional outcome in patients with advanced head and neck cancer: surgery and reconstruction with free flaps versus primary radiochemotherapy. Eur Arch Otorhinolaryngol. doi:10.1007/s00405-011-1642-7
van der van Bokhorst-de S, van Leeuwen PA, Kuik DJ, Klop WM, Snow GB et al (1999) The impact of nutritional status on the prognoses of patients with advanced head and neck cancer. Cancer 86(3):519–527
Wanebo HJ, Chougule P, Akerley WL 3rd, Koness RJ, McRae R, Nigri P et al (1997) Preoperative chemoradiation coupled with aggressive resection as needed ensures near total control in advanced head and neck cancer. Am J Surg 174(5):518–522
Wanebo H, Chougule P, Ready N, Safran H, Ackerley W, Koness RJ et al (2001) Surgical resection is necessary to maximize tumor control in function-preserving, aggressive chemoradiation protocols for advanced squamous cancer of the head and neck (stage III and IV). Ann Surg Oncol 8(8):644–650
Wong CH, Wei FC (2010) Microsurgical free flap in head and neck reconstruction. Head Neck 32(9):1236–1245
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Mücke, T., Koschinski, J., Wagenpfeil, S. et al. Functional outcome after different oncological interventions in head and neck cancer patients. J Cancer Res Clin Oncol 138, 371–376 (2012). https://doi.org/10.1007/s00432-011-1106-x
- Neck dissection
- Radiation therapy
- Surgical resection
- Oral cancer