Background: Total glossectomy is proven to be a superior treatment option for advanced tongue cancer. Despite its efficacy, the procedure is associated with profound morbidity, notably impacting Speech, swallowing, and overall quality of life. Limited therapeutic benefits and the potential for considerable morbidity render total glossectomy a subject of controversy.
Methods: We performed a multidimensional quality of life evaluation of long-term (more than 5 yrs.) total glossectomy survivors. In this study, we evaluated 25 total glossectomy survivors with comprehensive functional and quality of life outcomes using objective measures (London Speech Evaluation Scale, FOIS, 100 ml Water Challenge, FEES) and Patient-reported outcomes (SHI, PSS HN, EORTC QLQ 30 & HN35).
Results: EORTC QLQ 30 showed overall good global health status (M = 80 ± 20) and functional scale mean scores ranging from 87 to 91, despite issues in pain (M = 31.6 ± 31), swallowing (M = 23.3 ± 24), and Speech (26.1 ± 1). Speech outcomes revealed 80% with moderate to severe intelligibility impairment. Swallowing outcomes showed 84% requiring special food preparation, 24% exhibiting aspiration, and 72% having pharyngeal residue. Speech outcomes showed 88% having moderate-severe speech impairment, and Patient-reported speech outcomes indicated a mean SHI score of (M = 47.2 ± 42).
Conclusion: Patients undergoing total glossectomy report favourable long-term outcomes in global health-related quality of life despite moderate to severe impairments in objective speech and swallowing evaluations. These positive patient-reported outcomes support the consideration of total glossectomy as a viable treatment option if and when required, underscoring the importance of evaluating treatment outcomes through the patient-perceived quality of life.
The study on long-term outcomes for total glossectomy survivors revealed significant challenges in Speech, with 80% of patients experiencing moderate to severe issues with intelligibility, articulation, and overall speech impairment. Similarly, swallowing function was severely compromised, as 84% of survivors required special food preparation, and 24% had frank aspiration. Despite these objective difficulties, patients showed favourable five-year long-term outcomes in health-related quality of life. The EORTC QLQ scores supported this by showing good global health status, although they also highlighted specific issues like pain, swallowing difficulties, and challenges with social eating. The findings suggest a capacity for adaptation among survivors, as they adjust over time to the limitations imposed by total glossectomy, which is reflected in the generally positive quality of life scores despite significant functional deficits.
Keywords: FEES; Glossectomy survivors; Oral cancer; Performance status score; Quality of life; Speech outcomes; Swallowing outcomes; Total glossectomy.
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.