Long-Term Quality of Life in Patients With Maxillofacial Malignancies Who Have Undergone Craniofacial Resection: A Cross-Sectional Survivorship Study

Abstract

Purpose: The purposes were to investigate the postoperative, long-term quality of life (QoL) of patients with maxillofacial malignancies who underwent craniofacial resections that involved the skull base and to screen for potential predictors of QoL.

Patients and methods: We reviewed all patients who had undergone craniofacial resections as identified by the electronic medical record system from 2013 onward; we then applied our eligibility criteria to generate the study cohort. Each patient was asked to complete the Skull Base Inventory, a questionnaire that is scored from 0 to 100, during his or her regular postoperative follow-up. All demographic information and clinicopathologic variables were then collected and analyzed.

Results: A total of 25 patients who received treatment between March 2013 and March 2018 were consecutively enrolled and surveyed at 6 to 42 months (median, 15 months). The age at diagnosis ranged from 23 to 81 years (median, 42 years), with a female-to-male ratio of 1.1:1.0. The mean score for QoL was 67.56 ± 16.35. Univariate analysis found that being in the subgroup aged 20 to 40 years (β = -12.87 [95% confidence interval (CI), -25.54 to -0.21], P = .047), having the mesenchymal pathologic subtype (β = -18.80 [95% CI, -34.05 to -3.54], P = .018), and having involvement of the middle skull base (β = -15.00 [95% CI, -28.33 to -1.68], P = .029) could all significantly impact long-term QoL. A multiple linear regression model (R² = 36.4%, P = .007) included the latter 2 factors (β = -16.82 [95% CI, -31.06 to -2.59], P = .023, and β = -13.14 [95% CI, -25.35 to -0.94], P = .036, respectively).

Conclusions: The location of the involved skull base may be used as a guide for the surgical approach or incision design to improve patients' long-term QoL. However, this should not take precedence over the nature of malignancies as the pathologic subtype implied that patients with mesenchymal malignancies may pay the price of better QoL to survive.