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<p>Tumor site influences outcomes in oral squamous cell carcinoma (OSCC), driving variations in psychological distress and functional impairment post-treatment. Understanding site-specific burdens is critical for optimizing surgical and supportive care. To investigate correlations between tumor site (tongue vs. Buccal mucosa vs. Others) and psychological burden (depression, anxiety, stress), alongside functional impairments and quality of life (QOL) in OSCC patients. Prospective, longitudinal cohort study. From March 2022 to January 2024, 100 OSCC patients in Shimla, India, were assessed at diagnosis, 2 weeks, 1 month, and 6 months post-treatment using the Depression, Anxiety, Stress Scale (DASS-21) and EORTC QLQ-H&amp;N43. Treatments included surgery (8%), radiotherapy (3%), chemotherapy (2%), or combination therapy (87%). Tumor sites were lateral tongue (33%), buccal mucosa (14%), or others (53%). ANOVA and repeated measures ANOVA analyzed outcomes (<i>p</i> &lt; 0.05). Patients (86% male, mean age 53.6 ± 13.0 years) showed significant site-specific differences. Tongue cancers had higher 6-month depression (15.3 ± 4.8 vs. 11.9 ± 4.1 buccal mucosa, <i>p</i> = 0.008) and speech impairment (17.8 ± 3.6 vs. 13.9 ± 3.2, <i>p</i> = 0.015). Swallowing worsened more in tongue cancers (15.2 ± 3.7 vs. 12.0 ± 3.4, <i>p</i> = 0.009). Buccal mucosa cancers increased body image concerns (10.8 ± 2.5 vs. 9.1 ± 2.3 tongue, <i>p</i> = 0.038). Anxiety decreased (12.8 ± 4.7 to 4.6 ± 2.9, <i>p</i> &lt; 0.001), while stress rose (6.1 ± 3.5 to 11.2 ± 4.0, <i>p</i> &lt; 0.001). Combination therapy exacerbated swallowing (14.1 ± 3.8 vs. 8.5 ± 2.5 surgery-only, <i>p</i> = 0.025). Rural patients (55%) reported greater distress (<i>p</i> = 0.032). Tongue cancers impose heavier psychological and functional burdens, necessitating function-preserving surgeries and integrated psychological care. Buccal mucosa cancers require aesthetic focus. Multidisciplinary strategies are essential for OSCC management.</p>

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Correlation between Tumor Site and Psychological Burden in Oral Cancer Patients: A Comprehensive Analysis of Functional Impairments, Treatment Challenges, and Psychosocial Distress

  • 期刊论文

  • 发表日期：

    2025年9月26日

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  • Abhijeet Kamble,
  • Rangila Ram,
  • Manish Sahore,
  • Narotam Ghezta

摘要

Tumor site influences outcomes in oral squamous cell carcinoma (OSCC), driving variations in psychological distress and functional impairment post-treatment. Understanding site-specific burdens is critical for optimizing surgical and supportive care. To investigate correlations between tumor site (tongue vs. Buccal mucosa vs. Others) and psychological burden (depression, anxiety, stress), alongside functional impairments and quality of life (QOL) in OSCC patients. Prospective, longitudinal cohort study. From March 2022 to January 2024, 100 OSCC patients in Shimla, India, were assessed at diagnosis, 2 weeks, 1 month, and 6 months post-treatment using the Depression, Anxiety, Stress Scale (DASS-21) and EORTC QLQ-H&N43. Treatments included surgery (8%), radiotherapy (3%), chemotherapy (2%), or combination therapy (87%). Tumor sites were lateral tongue (33%), buccal mucosa (14%), or others (53%). ANOVA and repeated measures ANOVA analyzed outcomes (p < 0.05). Patients (86% male, mean age 53.6 ± 13.0 years) showed significant site-specific differences. Tongue cancers had higher 6-month depression (15.3 ± 4.8 vs. 11.9 ± 4.1 buccal mucosa, p = 0.008) and speech impairment (17.8 ± 3.6 vs. 13.9 ± 3.2, p = 0.015). Swallowing worsened more in tongue cancers (15.2 ± 3.7 vs. 12.0 ± 3.4, p = 0.009). Buccal mucosa cancers increased body image concerns (10.8 ± 2.5 vs. 9.1 ± 2.3 tongue, p = 0.038). Anxiety decreased (12.8 ± 4.7 to 4.6 ± 2.9, p < 0.001), while stress rose (6.1 ± 3.5 to 11.2 ± 4.0, p < 0.001). Combination therapy exacerbated swallowing (14.1 ± 3.8 vs. 8.5 ± 2.5 surgery-only, p = 0.025). Rural patients (55%) reported greater distress (p = 0.032). Tongue cancers impose heavier psychological and functional burdens, necessitating function-preserving surgeries and integrated psychological care. Buccal mucosa cancers require aesthetic focus. Multidisciplinary strategies are essential for OSCC management.