Implant-based dental rehabilitation in head and neck cancer patients after maxillofacial reconstruction with a free vascularized fibula flap: the effect on health-related quality of life

Johannes N Lodders; Gustaaf J C van Baar; Marije R Vergeer; Femke Jansen; Engelbert A J M Schulten; Birgit I Lissenberg-Witte; Irma M Verdonck-de Leeuw; Tymour Forouzanfar; Frank K J Leusink

doi:10.1007/s00520-022-06944-4

Implant-based dental rehabilitation in head and neck cancer patients after maxillofacial reconstruction with a free vascularized fibula flap: the effect on health-related quality of life

Support Care Cancer. 2022 Jun;30(6):5411-5420. doi: 10.1007/s00520-022-06944-4. Epub 2022 Mar 17.

Authors

Johannes N Lodders¹, Gustaaf J C van Baar², Marije R Vergeer³, Femke Jansen⁴, Engelbert A J M Schulten², Birgit I Lissenberg-Witte⁵, Irma M Verdonck-de Leeuw^{4

6}, Tymour Forouzanfar², Frank K J Leusink²

Affiliations

¹ Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Department of Oral and Maxillofacial Surgery/Oral Pathology, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. j.lodders@amsterdamumc.nl.
² Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Department of Oral and Maxillofacial Surgery/Oral Pathology, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
³ Department of Radiation Oncology, Amsterdam UMC, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
⁴ Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
⁵ Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
⁶ Department of Behavioural and Movement Sciences, Section Clinical Psychology, Vrije Universiteit Amsterdam Public Health, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.

Abstract

Purpose: To evaluate the effect of implant-based dental rehabilitation (IDR) on health-related quality of life (HRQoL) in head and neck cancer (HNC) patients after reconstruction with a free vascularized fibula flap (FFF).

Methods: Eligible patients were identified by retrospectively reviewing the medical records of patients treated in Amsterdam UMC-VUmc. HRQoL data were used from OncoQuest, a hospital-based system to collect patient-reported outcome measures in routine care. Data were used of the EORTC QLQ-C30 and QLQ-H&N 35 before FFF reconstruction (T₀) and after completing IDR (T₁). Data were statistically analysed with the chi-square test, independent samples t test and linear mixed models.

Results: Out of 96 patients with maxillofacial FFF reconstruction between January 2006 and October 2017, 57 patients (19 with and 38 without IDR) had HRQoL data at T₀ and T₁. In the cross-sectional analysis, patients with IDR scored significantly better at T₀ and T₁ on several EORTC domains compared to the patients without IDR. Weight loss was significantly different in the within-subject analysis between T₀ and T₁ for patients with IDR (p = 0.011). However, there were no significant differences in the mean changes of all the EORTC QLQ-C30 and EORTC QLQ-H&N35 scores between the defined timepoints for patients with IDR compared to those without.

Conclusions: In this study, no differences were found in the course of HRQoL in HNC patients who had undergone IDR after maxillofacial FFF reconstruction, compared to those who had not. Patients should be preoperatively informed to have realistic expectations regarding the outcome of IDR.

Keywords: Dental implants; Fibula free flap; Head and neck cancer; Quality of life; Rehabilitation.

MeSH terms

Cross-Sectional Studies
Fibula
Head and Neck Neoplasms* / surgery
Humans
Quality of Life*
Retrospective Studies