Quality of life of patients with oral cancer treated by primary surgery : preoperative and postoperative analysis

Introduction: The increasing prevalence of chronic degenerative diseases, especially various types of malignant lesions, shows a major change in the morbidity and mortality of the world population profile. According to the World Health Organization (WHO), there were 14,1 million incident cases and 8,2 million cancer deaths in 2012. Oral cancer is a serious and growing problem in many parts of the world. Brazilian male population is considered the third highest risk for oral cancer in the world, after countries like France and India. The treatment of oral cancer is undoubtedly related to a decrease in quality of life (QOL), which can generate significant functional, aesthetic and emotional changes. The measurement of QOL allows monitoring, as well as understanding of the real impact of the disease and its treatment on patients lives. Objective: To measure the QOL of patients treated with primary surgery for oral cancer, through an analysis of preoperative and postoperative. Methods: A prospective cross-sectional study in which 54 patients treated with primary surgery for oral cancer from August 2012 to October 2013 were included. Patients were treated at the Hospital Haroldo Juaçaba - Cancer Institute of Ceará (HHJ-ICC) in Fortaleza, Ceará, Brazil. For analysis of QOL, the questionnaire of the University of Washington (UW-QOL) for head and neck cancer (CCP) at pre and post-operative was used. The clinicopathological profile and lifestyle were also collected. Categorical data were analyzed by means of confidence intervals and Fisher exact or Chi-square test. The variation in scores QOL the preoperative to the postoperative period was assessed using the Wilcoxon test (nonparametric data). Data were exported to the Statistical Packcage for Social Sciences and adopted a confidence of 95% (p<0,05) in all analyzes. Results: The prevalence was higher in males (72,2%; p=0,018) with a mean of 61,1±13,9 years old, with the majority having completed elementary school (33,3%; p=0,001) or incomplete (33,3%; p=0,001) and natural in the state (63%; p<0,001). As for lifestyle, most of the selected patients were smokers (81,5%), alcoholic (63,0%) and worked out in the sun (77,8%). The lesions were more prevalent in language, followed by lip and oral floor and classified primarily as stage IV (40,8%) and I (34,7%). QOL analysis, comparing the first phase and immediate postoperative, showed a drop in appearance scores, activity, recreation, swallowing, chewing, talking, shoulder function, saliva, and especially the palate (p=0,001). As for the areas of pain, mood and anxiety had improved. On the importance of pain domains, mood and anxiety stood out, with statistical significance compared with the postoperative phase. In the postoperative period, the domains speech and shoulder function were also statistically significant compared to the previous time. In absolute terms had pain, anxiety and swallowing were quite cited preoperatively and chewing and swallowing postoperatively. Most patients rated their QOL related to health and general as good and very good in the postoperative period. Conclusion: The UW-QOL was an effective tool in the analysis of the sample. Although still the most widely used treatment, surgical resection in the treatment of oral malignant lesions contributed negatively to QOL, especially on the functional aspects of the stomatognathic system. Even with the worsening of individual domains, patients classified as positive their overall QOL and health-related postoperative. Clinical Relevance: Identification of the most affected areas and its importance throughout surgical treatment for subsequent performance in policies for prevention and care to these patients. The reflection and the search for new technologies in cancer treatment are necessary.Introdução: O aumento da prevalência de doenças crônico-degenerativas, especialmente os vários tipos de lesões malignas, mostra uma importante mudança no perfil de morbidade e mortalidade da população mundial. De acordo com dados da Organização Mundial de Saúde (OMS), houve 14,1 milhões de casos incidentes e 8,2 milhões de mortes por câncer em 2012. O câncer de boca é um problema grave e crescente em várias partes do mundo. A população masculina brasileira é considerada a terceira de maior risco para o câncer de boca no mundo, depois de países como França e Índia. A terapêutica do câncer oral é, sem dúvida, relacionada a uma diminuição na qualidade de vida (QV), podendo gerar significativas mudanças funcionais, estéticas e emocionais. A mensuração da QV permite o monitoramento, assim como a compreensão do real impacto da doença e seu tratamento na vida dos pacientes. Objetivo: Mensurar a QV de pacientes tratados com cirurgia primária para câncer de boca, por meio de uma análise pré-operatória e pós-operatória. Métodos: Estudo prospectivo transversal, no qual foram incluídos 54 pacientes tratados com cirurgia primária para câncer de boca no período de agosto de 2012 a outubro de 2013. Os pacientes foram atendidos no Hospital Haroldo Juaçaba – Instituto do Câncer do Ceará (HHJ-ICC) em Fortaleza, Ceará, Brasil. Para análise da QV, foi utilizado o questionário da Universidade de Washington (UW-QOL) para câncer de cabeça e pescoço (CCP) no momento pré e pós-operatório. O perfil clinicopatológico e o estilo de vida também foram coletados. Os dados categóricos foram analisados por meio de seus intervalos de confiança e teste Exato de Fisher ou Qui-quadrado. A variação dos escores de QV do pré-operatório ao pós-operatório foi avaliada por meio do teste de Wilcoxon (dados não-paramétricos). Os dados foram exportados para o Statistical Packcage for the Social Sciences e adotou-se uma confiança de 95% (p<0,05) para todas as análises. Resultados: A prevalência foi maior no sexo masculino (72,2%; p=0,018) com uma média de 61,1±13,9 anos de idade, sendo a maioria com ensino fundamental completo (33,3%; p=0,001) ou incompleto (33,3%; p=0,001) e naturais do interior do estado (63%; p