Social adaptation following radical resection and free flap reconstruction for oral cancer

Abstract

Objective: Understanding the extent of social reintegration is crucial in providing social support to patients. The incidence and treatment of oral cancer can result in functional and aesthetic impairments that significantly affect the daily lives of patients. Therefore, we aimed to determine the social adaptation status of patients after oral cancer surgery. Methods: Patients who had undergone resection and reconstructive surgery with free flaps for oral cancer between February 2017 and October 2020 and agreed to participate in this study were included. The social adaptation status of patients was assessed using the Japanese version of the Social Adaptation Self-evaluation Scale (SASS-J; higher scores denote better social adaptation) preoperatively and at 3- and 6-months postoperatively. Results: Thirty-four patients completed the SASS-J questionnaire. The median preoperative and 3- and 6-month postoperative SASS-J scores were 34 (26.5–39.25), 33.5 (25–38), and 33.5 (30–40), respectively, and did not differ significantly between these three categories. Analysis of covariance (ANCOVA) of 6-month postoperative SASS-J scores revealed significant differences for both the primary site of cancer (F = 6.6024, p = 0.0007) and marital status (F = 11.6866, p = 0.0019). Furthermore, multiple comparisons for the primary site of cancer indicated that the SASS-J scores of patients with tongue cancer were significantly lower than those of patients with mandibular cancer (p = 0.0178). Conclusions: These results indicate that the postoperative social adaptation status among patients who underwent oral cancer resection with reconstruction is worse in patients with tongue cancer and in those who are unmarried.

Keywords

• Oral cancer surgery
• Social adaptation
• Radical resection
• Free flap reconstruction