School of Medicine, University of California, San Francisco, California, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.
Laryngoscope. 2021 Feb;131(2):312-318. doi: 10.1002/lary.28723. Epub 2020 May 7.
OBJECTIVES/HYPOTHESIS: For early-stage oral tongue carcinoma and carcinoma in situ (ESOTCCIS), we evaluated patient-reported quality-of-life (QOL) outcomes following resection with primary closure (R-PC).
Retrospective review at an academic cancer center.
Thirty-nine ESOTCCIS patients (Tis, T1, T2) who underwent R-PC without radiation completed the University of Washington Quality of Life Questionnaire Version 4 (UW-QOL) at least 6 months since R-PC (mean = 2.39 years; range = 0.5-6.7 years). We compared UW-QOL scores for pain, swallowing, chewing, speech, and taste to established normative population scores. Multivariable regression analysis evaluated factors associated with QOL impairment.
ESOTCCIS patients who underwent R-PC in comparison to the normative population reported significantly worse mean speech (87.7 vs. 98, P < .001) and taste (85.6 vs. 95, P = .002) scores and no significant differences in mean pain (91.7 vs. 86, P = .96), swallowing (100 vs. 98, P = .98), chewing (97.4 vs. 94, P = .98) scores. For speech and taste, 59% (23/39) reported no postoperative change from baseline, whereas 41% (16/39) and 35.9% (14/39) reported mild impairment, respectively. Overall, postoperative QOL was reported as good, very good, or outstanding by 87.2% (34/39). Higher American Society of Anesthesiologists class, cT1 compared to CIS, and ventral tongue involvement were independently associated with worse speech. Age < 60 years was independently associated with worse taste.
ESOTCCIS patients who undergo R-PC without radiation can expect long-term swallowing, chewing, and pain to be in the normative range. Although a majority of patients can expect to achieve normative speech and taste outcomes, R-PC carries the risks of mild speech and/or taste impairments.
4 Laryngoscope, 131:312-318, 2021.
目的/假设：对于早期口腔舌癌和原位癌（ESOTCCIS），我们评估了原发性闭合切除（R-PC）后患者的生活质量（QOL）报告结果。
在学术癌症中心进行的回顾性研究。
39 例接受 R-PC 且未接受放疗的 ESOTCCIS 患者（Tis、T1、T2），在 R-PC 后至少 6 个月完成了华盛顿大学生活质量问卷第 4 版（UW-QOL）（平均=2.39 年；范围=0.5-6.7 年）。我们将 UW-QOL 疼痛、吞咽、咀嚼、言语和味觉评分与既定的正常人群评分进行了比较。多变量回归分析评估了与 QOL 受损相关的因素。
与正常人群相比，接受 R-PC 的 ESOTCCIS 患者报告的平均言语（87.7 对 98，P<0.001）和味觉（85.6 对 95，P=0.002）评分明显更差，而疼痛（91.7 对 86，P=0.96）、吞咽（100 对 98，P=0.98）和咀嚼（97.4 对 94，P=0.98）评分无显著差异。在言语和味觉方面，59%（23/39）报告术后与基线相比无变化，而 41%（16/39）和 35.9%（14/39）分别报告轻度受损。总体而言，87.2%（34/39）的患者报告术后 QOL 良好、非常好或优秀。较高的美国麻醉医师协会分级、cT1 与 CIS 相比以及舌腹受累与言语较差独立相关。年龄<60 岁与味觉较差独立相关。
未接受放疗的 ESOTCCIS 患者接受 R-PC 后，长期吞咽、咀嚼和疼痛可处于正常范围。尽管大多数患者可预期达到正常的言语和味觉结果，但 R-PC 存在轻度言语和/或味觉受损的风险。
4 级喉镜，131：312-318，2021 年。
