Patient-Reported Outcomes Following Surgical Management of Oral Cancer
Abstract
Introduction: Oral cavity cancers are a significant public health issue, particularly in South-Central Asia. While treatment efficacy has improved, the long-term impact on patients’ quality of life (QoL) requires further investigation. This exploratory study aimed to assess the long-term QoL of patients with oral cancer following surgical treatment in a single-center Iranian cohort. Materials and Methods: This retrospective, single-center cohort study involved 40 patients who underwent oral cancer surgery at Shariati Hospital, Tehran, between 2013 and 2023. Data were collected via structured telephone interviews using the validated Persian version of the University of Washington Quality of Life questionnaire (UW-QOL v4.0). Descriptive statistics were prioritized, with exploratory analyses to examine potential associations with demographic/clinical variables. Results: The mean age was 55.2 years (±10.8), and 60% were female. The buccal mucosa (52.5%) and tongue (30%) were the most common primary sites, with most patients (75%) diagnosed at advanced stages (III/IV). Pain was the most severely affected domain (mean score: 59.4), reported as a “significant problem” by 55% (22/40) of patients. Appearance, anxiety, and mood were also notably impaired. Shoulder function and saliva production were the best-preserved domains. Exploratory statistical analyses did not reveal significant associations between QoL scores and variables such as gender, disease stage, or age, though the study was underpowered for such comparisons (see Supplementary Tables S1–S6). Conclusion: In this exploratory cohort, patients reported considerable long-term detriment in QoL after oral cancer surgery, particularly regarding pain and psychosocial domains. The findings, while limited by sample size, underscore the necessity for comprehensive, multidisciplinary survivorship care focused on pain management, psychological support, and functional rehabilitation. Larger, multi-center studies are needed to identify reliable predictors of QoL in this population. Keywords: Oral cancer; Quality of life; Uw-qol questionnaire; Surgery; Post-treatment care; Survivorship.
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11. Weymuller EA Jr, Alsarraf R, Yueh B, Deleyiannis FW, Coltrera MD. Analysis of the performance characteristics of the University of Washington Quality of Life instrument and its modification (UW-QOL-R). Arch Otolaryngol Head Neck Surg. 2001;127(5):489-493.
12. Senkal HA, Hayran M, Karakaya E, Yueh B, Weymuller EA Jr, Hoşal AŞ. The validity and reliability of the Turkish version of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer. Am J Otolaryngol. 2012;33(4):417-426.
13. Rogers SN, Lowe D, Brown JS, Vaughan ED. The University of Washington head and neck cancer measure as a predictor of outcome following primary surgery for oral cancer. Head Neck. 1999;21(5):394-401.
14. Abbas S, Tariq MUU, Raheem A, et al. Assessment of Factors Affecting Quality of Life in Oral Squamous Cell Carcinoma Patients Using University of Washington Quality of Life Questionnaire. Cureus. 2019;11(1):e3904.
15. Pouresmaeil A, Sohrabpour S, Aghaei B, et al. Persian version of the University of Washington Quality of Life Questionnaire (UW-QOL): Reliability and Validity Study. Arch Anesth Crit Care. 2024;10(Suppl 1):487-492.
16. Terrell JE, Ronis DL, Fowler KE, et al. Clinical predictors of quality of life in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 2004;130(4):401-408.
17. Terrell JE, Welsh DE, Bradford CR, et al. Pain, quality of life, and spinal accessory nerve status after neck dissection. Laryngoscope. 2000;110(4):620-626.
18. Pinna R, Campus G, Cumbo E, Mura I, Milia E. Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage. Ther Clin Risk Manag. 2015;11:171-188.
19. Simpson MC, Challapalli SD, Cass LM, et al. Impact of gender on the association between marital status and head and neck cancer outcomes. Oral Oncol. 2019;89:48-55.
20. Inverso G, Mahal BA, Aizer AA, Donoff RB, Chau NG, Haddad RI. Marital status and head and neck cancer outcomes. Cancer. 2015;121(8):1273-1278.
2. Rath GK, Parikh PM, Hukku S, et al. Indian Council of Medical Research consensus document for the management of buccal mucosa cancer. Indian J Med Paediatr Oncol. 2014;35(2):136-139.
3. James A, Janakiram C, Meghana RV, et al. Impact of oral conditions on oral health-related quality of life among Indians—a systematic review and meta-analysis. Health Qual Life Outcomes. 2023;21(1):102.
4. Al-Sharif RM, Batwa DY, Alotaibi TN, et al. Epidemiology and types of oral cancer. Int J Community Med Public Health. 2022;9(2):1017-1022.
5. Sargeran K, Murtomaa H, Safavi SM, Vehkalahti M, Teronen O. Malignant oral tumors in Iran: ten-year analysis on patient and tumor characteristics of 1042 patients in Tehran. J Craniofac Surg. 2006;17(6):1230-1233.
6. Malik UU, Zarina S, Pennington SR. Oral squamous cell carcinoma: Key clinical questions, biomarker discovery, and the role of proteomics. Arch Oral Biol. 2016;63:53-65.
7. Colevas AD, Cmelak AJ, Pfister DG, et al. NCCN Guidelines® Insights: Head and Neck Cancers, Version 2.2025. J Natl Compr Canc Netw. 2025;23(2):2-11.
8. Bugshan A, Farooq I. Oral squamous cell carcinoma: metastasis, potentially associated malignant disorders, etiology and recent advancements in diagnosis. F1000Res. 2020;9:229.
9. Murphy BA, Dietrich MS, Wells N, et al. Reliability and validity of the Vanderbilt Head and Neck Symptom Survey: a tool to assess symptom burden in patients treated with chemoradiation. Head Neck. 2010;32(1):26-37.
10. Vissink A, Mitchell JB, Baum BJ, et al. Clinical management of salivary gland hypofunction and xerostomia in head-and-neck cancer patients: successes and barriers. Int J Radiat Oncol Biol Phys. 2010;78(4):983-991.
11. Weymuller EA Jr, Alsarraf R, Yueh B, Deleyiannis FW, Coltrera MD. Analysis of the performance characteristics of the University of Washington Quality of Life instrument and its modification (UW-QOL-R). Arch Otolaryngol Head Neck Surg. 2001;127(5):489-493.
12. Senkal HA, Hayran M, Karakaya E, Yueh B, Weymuller EA Jr, Hoşal AŞ. The validity and reliability of the Turkish version of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer. Am J Otolaryngol. 2012;33(4):417-426.
13. Rogers SN, Lowe D, Brown JS, Vaughan ED. The University of Washington head and neck cancer measure as a predictor of outcome following primary surgery for oral cancer. Head Neck. 1999;21(5):394-401.
14. Abbas S, Tariq MUU, Raheem A, et al. Assessment of Factors Affecting Quality of Life in Oral Squamous Cell Carcinoma Patients Using University of Washington Quality of Life Questionnaire. Cureus. 2019;11(1):e3904.
15. Pouresmaeil A, Sohrabpour S, Aghaei B, et al. Persian version of the University of Washington Quality of Life Questionnaire (UW-QOL): Reliability and Validity Study. Arch Anesth Crit Care. 2024;10(Suppl 1):487-492.
16. Terrell JE, Ronis DL, Fowler KE, et al. Clinical predictors of quality of life in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 2004;130(4):401-408.
17. Terrell JE, Welsh DE, Bradford CR, et al. Pain, quality of life, and spinal accessory nerve status after neck dissection. Laryngoscope. 2000;110(4):620-626.
18. Pinna R, Campus G, Cumbo E, Mura I, Milia E. Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage. Ther Clin Risk Manag. 2015;11:171-188.
19. Simpson MC, Challapalli SD, Cass LM, et al. Impact of gender on the association between marital status and head and neck cancer outcomes. Oral Oncol. 2019;89:48-55.
20. Inverso G, Mahal BA, Aizer AA, Donoff RB, Chau NG, Haddad RI. Marital status and head and neck cancer outcomes. Cancer. 2015;121(8):1273-1278.
| Files | ||
| Issue | Vol 13, No 1 (Winter 2026) | |
| Section | Original Article(s) | |
| Keywords | ||
| Oral cancer; Quality of life; Uw-qol questionnaire; Surgery; Post-treatment care; Survivorship. | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Mehri S, Karimi A, Farhangiyan M, Abbasi AJ. Patient-Reported Outcomes Following Surgical Management of Oral Cancer. J Craniomaxillofac Res. 2026;13(1):52-61.
