Longitudinal changes in the quality of life of oral cancer patients during the perioperative period.

Background: There are few quality of life (QOL) studies that have focused on the experiences of oral cancer patients. Therefore, the present study aimed to investigate how the QOL for patients with oral cancer changed perioperatively.

Methods: Eighty-three participants undergoing radical therapy completed assessments of QOL at pre-treatment, treatment completion, and 1-, 3-, and 6-months post-treatment. The Japanese version of the FACT-H&N, comprising the subscales of "physical well-being (PWB)," "social/family well-being (SWB)," "emotional well-being (EWB)," "functional well-being (FWB)," and "additional head- and neck-specific concerns(HN)" was used to assess QOL. There were two study groups: those who required reconstructive surgery (r+, 31 patients) and those who did not (r-, 52 patients).

Results: The FACT-H&N, PWB, FWB, and HN, were lowest at treatment completion due to declines; then, it showed significant improvement over time (p < 0.05). SWB was the highest at the completion of treatment, and thereafter decreased significantly until 3 months after treatment (p < 0.05). EWB was the lowest before treatment but improved over time (p < 0.01). HN was significantly lower at 6 months after treatment than before treatment (p < 0.05). The QOL of the r+ group was significantly lower than that of the r- group (p < 0.01).

Conclusions: The treatment-associated declines in subscale area may be compensated for by gains in other subscale areas. Psychological support is better introduced prior to cancer treatment. As it is often difficult to recover from declines in HN functioning subscale, strategies that promote compensation in other areas must be explored. Clinicians should become thoroughly familiar with how patients' QOL changes over time and provide holistic treatments that honor patients' autonomy.