Background:
Nutritional status is a major concern for head and neck cancer patients from diagnosis to survivorship. HNC and its treatment impair oral intake by compromising anatomical structures. After tumour ablation with free-flap reconstruction and adjuvant chemo-radiation, prolonged enteral feeding via gastrostomy is often required, though predicting this need is complex.
Aims and Objectives:
To assess oral intake following resection and free flap reconstruction of advanced tongue tumours. The primary outcome was gastrostomy dependence at six months post-treatment. The secondary outcome was oral intake, measured by the Functional Oral Intake Scale (FOIS).
Methodology:
This observational cohort study retrospectively reviewed a three-year prospectively maintained database. Patients undergoing surgery and free flap reconstruction for tongue SCC were included. Patient demographics, disease and treatment-related factors, and oral intake at baseline and six months were analyzed.
Results:
Eighteen patients were included, 67% with pT4 disease. Reconstruction involved radial forearm (44%), anterolateral thigh (44%), and fibular flaps (11%). At six months, eight patients (50%) required gastrostomy. Two subtotal glossectomy cases (20%) avoided gastrostomy. The mean FOIS was 4.3 (SD 2.1).
Conclusion:
Impaired nutrition affects survival in oral cancer. Half of patients required gastrostomy, highlighting the complexity of predicting enteral feeding needs in this cohort.