Age- and localization-dependent functional and psychosocial impairments and health related quality of life six months after OSCC therapy

Oral Oncol. 2018 Jun:81:61-68. doi: 10.1016/j.oraloncology.2018.04.011. Epub 2018 Apr 18.

Abstract

Objectives: The aim of the current study was to evaluate the functional and psychosocial impacts and changes in overall quality of life (QoL) following oral squamous cell carcinoma (OSCC) therapy in different age groups and in different oral locations.

Materials and methods: The study assessed questionnaire responses from patients with OSCC (n = 1319) after 6 months of oncologic therapy, as collected in the DÖSAK Rehab Study. Oncological variables, dental status, sensory, QoL, psychosocial outcomes and coping strategies in younger (45-60 years) and older (61-100 years) patients were assessed for different OSCC locations including the entire oral cavity, maxilla, mandible and others besides the maxilla and mandible.

Results: Younger patients were generally less satisfied with their dental status and experienced more sensory and QoL impairments, as well as more psychological burden, compared to the older patients. Depending on the age group, different coping strategies were used. Oncologic therapy targeted to the mandible and other locations besides the maxilla and mandible led to the strongest sensory and QoL limitations.

Conclusions: Regardless of age, oncologic OSCC therapy leads to profound sensory and psychosocial restrictions and to limitations in QoL. Reasons for the poorer functional and QoL outcomes in younger patients include a more invasive treatment and a lower psychosocial resilience. The identification of patients with depressive and dysfunctional coping strategies should be carried out for all ages, but especially in younger patients, in order to develop functional coping strategies through individualized counseling, treatment and rehabilitation.

Registration of clinical trials: Observational study, therefore not required.

Keywords: Age; Coping strategies; Dental status; Function; Oncology; Oral cancer; Psychosocial outcome; Quality of life.

MeSH terms

  • Adaptation, Psychological
  • Age Factors*
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / physiopathology
  • Carcinoma, Squamous Cell / psychology
  • Carcinoma, Squamous Cell / therapy*
  • Cross-Sectional Studies
  • Dentures
  • Facial Nerve Diseases / etiology
  • Female
  • Humans
  • Hyperesthesia / etiology
  • Male
  • Middle Aged
  • Mouth Neoplasms / physiopathology
  • Mouth Neoplasms / psychology
  • Mouth Neoplasms / therapy*
  • Quality of Life*
  • Social Behavior
  • Tooth Loss / etiology