Long-term health-related quality of life in oral cancer survivors following microvascular tongue reconstruction.

Background: Evaluation of long-term health-related quality of life (HRQOL) is essential for optimization of functional and psychological outcomes in head and neck cancer survivors. However, few studies have assessed long-term HRQOL in survivors following microvascular tongue reconstruction.

Methods: A retrospective, cross-sectional study was performed, including all consecutive patients who underwent microvascular reconstruction following tongue cancer resection between 2010 and 2020. The primary outcome was HRQOL, assessed using the FACE-Q Head and Neck Cancer Module at least 3 years after surgery. Patients were grouped by the extent of the resection: partial or hemiglossectomy versus (sub)total glossectomy. Multivariable analyses were performed between clinical variables and HRQOL.

Results: Overall, 77 of 108 invited patients with a microvascular tongue reconstruction could be included with a mean follow-up of 7.9 years (SD 2.6) after surgery. Partial or hemiglossectomy was performed in 66 patients (86 %) and (sub)total glossectomy in 11 patients (14 %). In the long-term, mostly functional domains (eating, oral competence, salivation, speech and swallowing) and psychological domains of eating distress and speaking distress were affected. In multivariable analyses, postoperative radiotherapy was associated with worse speech (p = 0.002) and swallowing function (p = 0.027). (Sub)total glossectomy was significantly associated with worse speech (p = 0.011). Older age at surgery was significantly associated with poorer oral competence (p = 0.004). Females had significantly lower scores for the domain of swallowing (p = 0.044).

Conclusions: Long-term survivors after tongue reconstruction mainly report functionally-related HRQOL deficits. These long-term results can serve to enhance symptom management and may aid in managing patient expectations regarding long-term HRQOL.