Паёми Сино (Mar 2021)

INFLUENCE OF PLASTIC AND RECONSTRUCTIVE SURGERY ON THE QUALITY OF LIFE OF PATIENTS WITH LOCALLY ADVANCED HEAD AND NECK CANCER

  • I.K. NIYAZOV,
  • D.R. SANGINOV,
  • Z.KH. KHUSEYNZODA,
  • N.I. BAZAROV

DOI
https://doi.org/10.25005/2074-0581-2021-23-1-46-52
Journal volume & issue
Vol. 23, no. 1
pp. 46 – 52

Abstract

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Objective: A comparative assessment of the quality of life (QOL) parameters in patients with head and neck cancer (HNC) depending on the methods of reconstruction. Methods: A prospective and retrospective observation and follow-up of 169 patients with HNC aged from 25 to 92 years old was carried out. The main group included 108 (63.9%) patients, who underwent one-stage reconstruction of surgical defects by 132 various pedicle flaps with axial type of vascularization: myocutaneous 65 (49.2%), fasciocutaneous 56 (42.4%) and other 11 (8.2%). The control group consisted of 68 (36.1%) patients to whom the surgery was completed with minimal reconstruction to the defect with local tissues or free skin graft. The performance status and QOL of the patients were assessed with Karnovsky Scale, ECOG-Performance Status Scale and the EORTC QLQ-H&N-35 questionnaire. Results: The baseline performance status of patients in the study and control groups was at the same level – in the range between 40-80 points according to the Karnovsky Scale. After surgery, changes in the general condition of patients in both groups were achieved towards improvement – in the range from 60 to 100 points. Evaluation of the patients` ECOG performance status before and after surgery showed that postoperatively, this status changed from ЕСОG 1-2 to ЕСОG 0 in 63.9% of patients in the main group and 37.7% in the control group. The analysis of the results of the QOL EORTC-QLQ-C30/H&N35 questionnaire revealed significant positive changes in all parameters of the QOL of patients of the main group, and among the patients of the control group after surgery no positive changes were noted. Thus, statistically significant positive results were obtained for the parameters of the QOL in patients of the main group for all three assessment tools. Conclusion: Despite the complexity and versatility of the assessment, and the subjective nature of the QOL parameters, we can conclude that simultaneous reconstructive surgery for locally advanced head and neck cancer with pedicle flaps has a positive effect on the QOL of patients and accelerates their rehabilitation.

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