239P - Prospective evaluation of difference in patient-reported swallowing outcomes and quality of life of tongue vs bucco-alveolar complex cancers treated with ablative surgery

Background

Oral cancer surgery includes radical resections of the mandible and tongue, affecting the functional swallowing outcomes. However, risk factors and swallowing outcomes are not the same for all subsites of oral cancer. The present study aimed to assess the difference in patient-reported swallowing function and quality of life after primary surgical resection in tongue vs bucco- alveolar complex (BAC) malignancies.

Methods

Study included oral cancer patients requiring mandibulectomy for BAC subsite and at least hemi-glossectomy for tongue, all reconstructed with pedicle flaps at our institute from Dec 2019 to Dec 2021. The Sydney Swallow Questionnaire (SSQ) and Functional oral intake scale (FOIS) were used to assess swallowing outcomes after six months DFS. WHO BREF questionnaire was used to assess health-related quality of life.

Results

The final analysis included 66 patients. The median age was 48 yrs and majority are males (92.4%). BAC constituted 63.6%, and tongue lesions were 36.4%. Tumours with cT3 and T4 are 59% of BAC and 46% of tongue lesions. In BAC, 85% underwent segmental mandibulectomy, and 87% of tongue lesions were treated with hemiglossectomy. 85.7% of BAC and 92% of tongue lesions received adjuvant radiation. Trismus and xerostomia were present in 71.4%, 85% in BAC and 50%, 75% in tongue lesions, respectively. The mean SSQ score was (282.6, SD= 95), (222.5, SD=96) BAC and tongue, respectively. Advanced T stage (p=0.07), Multimodality treatment (p=0.01), lymphedema (p=0.03), Trismus (p=0.01), Dysgeusia (p=0.01), xerostomia (p=0.01) in BAC lesions. Advanced T stage (p=0.007), Multimodality treatment (p=0.04), lymphedema (p=0.03), Dysgeusia (p=0.01) in tongue lesions are associated with poor outcomes. Almost 88% of BAC lesions required special food preparation for swallowing (FOIS 5). However, only 16.7% of tongue lesions required special preparation. There is a trend toward better health-related quality of life (HRQOL) in tongue lesions.

Conclusions

There is a difference in swallowing results between tongue and BAC cancers. Tongue lesions had more reasonable swallowing outcomes. However, overall, HRQOL is comparable between both subsites.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.