Quality Of Life After Oral Cancer Resection And Free Flap Reconstruction

Objective: The study aimed to investigate the quality of life of patients with oral cancer in northeast China after immediate free flap reconstruction.The differences of Ulnar Forearm Free Flap(UFFF),Radial Forearm Free Flap(RFFF)and Anterolateral Thigh Flap(ALTF)in reconstruction are also compared.Methods: From January 2014 to December 2017,59 patients who received the treatment at the Department of Oral and Maxillofacial Surgery,School of Stomatology,China Medical University were enrolled in the study(24 patients underwent ALTF reconstruction,25 underwent RFFF reconstruction,and 10 underwent UFFF reconstruction).Six months after reconstruction,the quality of life was assessed by using the University of Washington Quality of Life(UWQOL)Questionnaires and the 14-item Oral Health Impact Profile(OHIP-14).Results: The hospital stay in the RFFF group was significantly longer than that in the UFFF group.The flap size in the ALTF group was significantly bigger than the RFFF and UFFF group.There were no significant differences with respect to age(P =0.842),gender(P =0.082),work(P =0.243),tumor site(P =0.583),operative time(P =0.278),cancer stage(P =0.825),T stage(P =0.548),pathological type(P =0.592),adjunctive therapy(P =0.597)or number of vascular anastomoses(P =0.199)among the three groups.The appearance and swallowing differences were significant in the UWQOL scores of the three groups(P <0.05).The appearance score of the ALTF group was significantly higher than that of the RFFF and UFFF group,and the swallowing score of RFFF and UFFF group were significantly higher than that of the ALTF group,there was no significant difference between group RFFF and group UFFF(P >0.05).There were significant differences in the social disability of OHIP-14 scores between the three groups(P <0.05),and the ALTF group score was significantly lower than the RFFF group,there was no significant difference between group RFFF and group UFFF(P >0.05).Conclusions: UFFF,RFFF and ALTF are used to reconstruct the defects after oral cancer resection,which will significantly affect the patients' quality of life.The results of the overall reconstruction of three kinds of free flaps are similar,and ALTF is slightly better than RFFF and UFFF.This study plays a certain role in the discussion of reconstruction method for oral cancer postoperative defects between surgeons and patients.