ORIGINAL RESEARCH article
Front. Oncol.
Sec. Head and Neck Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1630458
This article is part of the Research TopicMultidisciplinary Management of Oral Cancer: Diagnosis, Treatment, and RehabilitationView all 14 articles
Impact of cervical osteoarthritis on quality of life after free flap reconstruction in head and neck cancer
Provisionally accepted
Wei Du1*
Yili Li2Xu Zhang1
Junhui Yuan1Yibao Sun2Zhe Shao2Shuang Chen2Yaojun Dai2,3Xiaoguang Zhou2Yong Yang2*Wei Mei2*- 1Henan Provincial Cancer Hospital, Zhengzhou, China
- 2Zhengzhou Orthopedic Hospital, Zhengzhou, China
- 3zhengzhou, Zhengzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Head and neck squamous cell carcinoma (HNSCC) often requires free flap reconstruction, which involves extensive cervical manipulation. Concurrently, cervical osteoarthritis is increasingly prevalent due to modern lifestyle factors. This study investigates the impact of cervical osteoarthritis on quality of life (QoL) in HNSCC patients undergoing free flap reconstruction. Methods: A retrospective analysis of HNSCC patients who underwent free flap reconstruction was conducted. Patients were stratified by cervical osteoarthritis status and assessed using the Neck Disability Index (NDI), EORTC QLQ-C30, and QLQ-HN35 questionnaires at preoperative, postoperative, and follow-up intervals (3, 6, and 12 months post-adjuvant therapy). Propensity score matching (1:1) adjusted for confounding factors. Results: A total of 60 patients were analyzed. At baseline, cervical osteoarthritis was associated with lifting dysfunction (p=0.004) and nausea/vomiting (p<0.05). Postoperatively, transient impairments in driving, sleeping, and swallowing were noted in the osteoarthritis group, particularly within 3 months (p<0.05). Persistent fatigue was reported, but emotional function scores were superior in this group (p<0.05). No significant differences in QoL were observed based on osteoarthritis subtype. Response rates declined over time, primarily due to cancer recurrence. Conclusions: Cervical osteoarthritis correlates with transient postoperative functional impairments and persistent fatigue but does not adversely affect long-term QoL. Emotional resilience in these patients suggests adaptive coping mechanisms. These findings underscore the need for targeted preoperative counseling and rehabilitation to address short-term challenges while leveraging patients' psychosocial strengths. This study provides critical insights for optimizing patient-centered care in HNSCC reconstruction.
Keywords: Head and neck squamous cell carcinoma, cervical osteoarthritis, Quality of Life, free flap, Propensity score matching
Received: 17 May 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Du, Li, Zhang, Yuan, Sun, Shao, Chen, Dai, Zhou, Yang and Mei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wei Du, Henan Provincial Cancer Hospital, Zhengzhou, China
Yong Yang, Zhengzhou Orthopedic Hospital, Zhengzhou, China
Wei Mei, Zhengzhou Orthopedic Hospital, Zhengzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.