肿瘤切除术后 1 年随访时口腔和口咽癌患者的生存和生活质量。
Survival and quality of life of patients with oral and oropharyngeal cancer at 1-year follow-up of tumor resection.
机构信息
School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
出版信息
J Appl Oral Sci. 2010 May-Jun;18(3):279-84. doi: 10.1590/s1678-77572010000300015.
OBJECTIVE
This study aimed to assess the survival and life quality evolution of patients subjected to surgical excision of oral and oropharyngeal squamous cell carcinoma.
MATERIAL AND METHODS
Forty-seven patients treated at a Brazilian healthcare unit specialized in head and neck surgery between 2006 and 2007 were enrolled in the study. The gathering of data comprised reviewing hospital files and applying the University of Washington Quality of Life (UW-QOL) questionnaire previously and 1 year after the surgery. Comparative analysis used Poisson regression to assess factors associated with survival and a paired t-test to compare preoperative and 1-year postoperative QOL ratings.
RESULTS
1 year after surgery, 7 patients were not found (dropout of the cohort); 15 had died and 25 fulfilled the UW-QOL again. The risk of death was associated with having regional metastasis previously to surgery (relative risk=2.18; 95% confidence interval=1.09-5.17) and tumor size T3 or T4 (RR=2.30; 95%CI=1.05-5.04). Survivors presented significantly (p<0.05) poorer overall and domain-specific ratings of quality of life. Chewing presented the largest reduction: from 74.0 before surgery to 34.0 one year later. Anxiety was the only domain whose average rating increased (from 36.0 to 70.7).
CONCLUSIONS
The prospective assessment of survival and quality of life may contribute to anticipate interventions aimed at reducing the incidence of functional limitations in patients with oral and oropharyngeal cancer.
目的
本研究旨在评估接受口腔和口咽鳞状细胞癌手术切除的患者的生存和生活质量演变。
材料与方法
2006 年至 2007 年间,巴西一家头颈外科专业医疗机构收治了 47 例患者。数据收集包括查阅医院病历和应用华盛顿大学生活质量(UW-QOL)问卷,分别在手术前和手术后 1 年进行。采用泊松回归分析评估与生存相关的因素,采用配对 t 检验比较术前和术后 1 年的生活质量评分。
结果
术后 1 年,有 7 名患者未找到(队列脱落);15 人死亡,25 人再次完成 UW-QOL 问卷。手术前存在区域性转移(相对风险=2.18;95%置信区间=1.09-5.17)和肿瘤大小 T3 或 T4(RR=2.30;95%CI=1.05-5.04)与死亡风险相关。幸存者的整体和特定领域的生活质量评分明显更差(p<0.05)。咀嚼功能的下降最明显:从术前的 74.0 分下降到术后 1 年的 34.0 分。焦虑是唯一平均评分增加的领域(从 36.0 分增加到 70.7 分)。
结论
前瞻性评估生存和生活质量有助于预测干预措施,以减少口腔和口咽癌患者功能受限的发生率。
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