Early return to work is possible after transoral robotic surgery (TORS) in carefully selected patients with oropharyngeal squamous cell carcinoma

IF 4 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Lorne Green , Lachlan McDowell , Fiona Ip , Mario Tapia , Meiling Zhou , Michael T. Fahey , Benjamin Dixon , Matthew Magarey
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Abstract

Introduction

The aims of this study were to investigate the rate and time to return to work (RTW) after transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) and to explore the impact of disease or work-related factors leading to variations in RTW outcomes.

Methods

Cross-sectional survey of disease, socioeconomic, work-related and health-related quality of life (HR-QOL). Qualitative analysis of responses for facilitators and barriers to RTW.

Results

A total of 47 participants employed at diagnosis were included in the study, with an average age 56 years. Median survey time 3.2 years. 22 participants underwent TORS only with 25 undergoing TORS with adjuvant therapy. 93.6 % had stage 1 disease. 95.7 % of participants RTW after TORS with a mean time of 13.6 weeks. Patients returned earlier after TORS alone compared to those requiring adjuvant treatment (10 weeks vs. 17 weeks; p = 0.13) Overall high HR-QOL metrics for all patients, with those undergoing adjuvant having significantly poorer outcomes for the dry mouth/sticky saliva (9.1 vs 41.3, p=<0.001) items. Qualitative analysis of free text responses showed facilitators and barriers to RTW fell under four main categories: physical, phycological/emotional, financial and workplace.

Conclusion

High rate of RTW amongst patients after TORS, which is the highest reported amongst head and neck cancer literature to date. Participants returned earlier after surgery only compared to adjuvant treatment, but both groups reported high HR-QOL metrics. Physical effects of treatment, including fatigue and oral dysfunction were some of the main barriers to RTW; whereas flexible working arrangements and support from employer/colleagues were major facilitators.

经过精心挑选的口咽鳞癌患者接受经口机器人手术(TORS)后可早日重返工作岗位
引言 本研究旨在调查口咽鳞状细胞癌(OPSCC)经口机器人手术(TORS)后重返工作岗位(RTW)的比例和时间,并探讨疾病或工作相关因素对RTW结果差异的影响。结果共有 47 名确诊时已就业的参与者参与研究,平均年龄 56 岁。调查时间中位数为 3.2 年。22 名参与者仅接受了 TORS,25 名接受了 TORS 和辅助治疗。93.6%的患者病情为 1 期。95.7%的患者在接受 TORS 治疗后能够继续工作,平均时间为 13.6 周。与需要辅助治疗的患者相比,仅接受 TORS 治疗的患者复诊时间更早(10 周 vs. 17 周;p=0.13)。所有患者的 HR-QOL 指标总体较高,接受辅助治疗的患者在口干/唾液粘稠项目上的结果明显较差(9.1 vs. 41.3,p=<0.001)。对自由文本回答的定性分析显示,复工的促进因素和障碍主要分为四类:身体、生理/情感、经济和工作场所。与辅助治疗相比,仅在手术后患者就能更早地重返工作岗位,但两组患者的 HR-QOL 指标都很高。治疗对身体的影响,包括疲劳和口腔功能障碍,是复工的一些主要障碍;而灵活的工作安排和雇主/同事的支持则是复工的主要促进因素。
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来源期刊
Oral oncology
Oral oncology 医学-牙科与口腔外科
CiteScore
8.70
自引率
10.40%
发文量
505
审稿时长
20 days
期刊介绍: Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.
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